Positive airway pressure adherence related to relationship satisfaction

Key takeaways:

• In partnerships involving someone with sleep apnea, both parties are impacted by the disorder.
• When patients had better sleep efficiency, both patients and partners reported higher relationship satisfaction.

Individuals with obstructive sleep apnea and their partners both reported relationship satisfaction when the patient consistently used positive airway pressure at night, according to research presented at SLEEP 2024.

“Partners, whether you include them or not, are intrinsically involved in both the diagnosis and treatment of sleep apnea,” Wendy Troxel, PhD, senior behavioral scientist at RAND and licensed clinical psychologist, told Healio. “Sleep apnea, in addition to having many health consequences for the patient, also has consequences for the bed partner. They’re often the hidden casualties of untreated sleep apnea.

“It’s time we stop looking at sleep apnea as just an individual illness because it really does impact both members of a couple from diagnosis through treatment,” she added.

Troxel and colleagues assessed 36 couples (mean age, 63.06 years), all of which included one individual with OSA starting positive airway pressure (PAP), to find out the relationship between 3-month treatment adherence, sleep efficiency and sleep duration and self-reported relationship satisfaction and conflict.

At 3 months, when patients were more adherent to PAP (defined as at least 4-hour usage per night on average), both patients with OSA and their partners reported elevated levels of relationship satisfaction (P = .01).

Researchers also found a link between this degree of PAP adherence and reduced levels of relationship conflict (P = .04) reported by both individuals in the couple.

“It was very interesting that ... if individuals newly diagnosed with sleep apnea use their PAP more frequently, both they and their partners had higher relationship satisfaction and lower conflict,” Troxel said.

Further, when the partner with OSA was sleeping better (based on objectively measured sleep efficiency), both partners reported higher relationship satisfaction (P = .04).

The impact of sleep duration on relationship satisfaction did not follow the same pattern of agreement between patient and partner. When patients with OSA had longer total sleep time, they reported better relationship satisfaction (P = .01). But unexpectedly, when partners had longer total sleep time, this was associated with lower relationship satisfaction in the patient (P = .045).

“It is unclear why longer partner total sleep time was associated with lower patient satisfaction,” Troxel said. “Speculatively, it might indicate that patients felt less connected with their partner, particularly if they were on different sleep schedules.”

Reflecting on the study findings, Troxel highlighted the importance of partners.

“Partners are a primary motivator to get treatment,” she said. “It’s very important to engage the partner to be supportive of the patient in starting their sleep apnea treatment because adjusting to CPAP is not an easy experience.

“If there’s a partner available, partners can be a positive source of social support and encouragement,” she added.

When asked how clinicians should interpret these results, Troxel said they can be used as a reason for convincing patients to continue PAP use.

“Our findings show that there’s not only benefits for the patients’ own individual health and well-being but also for their relationship health,” she said. “If they’re not going to do it for themselves, they should do it for the sake of their relationship and for their partner.”

Since this study was composed of highly educated, very motivated and mainly white individuals, future studies will consist of a larger, more diverse population, Troxel told Healio.

“We’re in the process of adapting a couples-based treatment [WePAP] for more diverse couples, including an adaptation for Hispanic couples,” she said. “There will be a Spanish and English language version, and we’re going through a cultural adaptation process to make it more relevant to Hispanic couples.

“We hope to do more clinical research in terms of cultural adaptations for other diverse groups who really remain undertreated for sleep apnea,” Troxel continued.

Reference:

• Study links sleep apnea treatment and happier, healthier relationships. https://www.sleepmeeting.org/study-links-sleep-apnea-treatment-and-happier-healthier-relationships/. Published May 30, 2024. Accessed May 31, 2024.