Personality correlates of adherence with continuous positive airway pressure (CPAP)

Introduction: Adherence with continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA) has been problematic. Understanding the factors associated with non-adherence may assist with psychosocial interventions. Objective: The objective of this study was to examine the relationship between adherence and three measures of personality and coping strategies. Methods: Ratings on the behavioral inhibition system/ behavioral activation system (BIS/BAS) scales, the ways of coping inventory, and a broad personality measure (mini-IPIP) were analyzed with a binary logistic regression among 63 subjects, adult men (31) and women (32), diagnosed with OSA. Data from the CPAP device was obtained following initial 30 days at minimum, with adherence defined as >4 h/night on 70% of nights. Results: Elevated BIS was the strongest predictor of nonadherence (r=-.452, p<.01), followed by neuroticism. The regression correctly classified 73% of participants as adherent or nonadherent. Conclusion: Nonadherence is associated with elevated BIS scores and neuroticism, which indicates that personality factors play a role in determining adherence to CPAP. Although more research is needed to draw firm conclusions, the differences noted in BIS may also point toward differences in neurophysiological function. The BIS scale may be a useful tool for predicting nonadherence and assist with the development of intervention strategies that will increase adherence.