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Challenges and motivating factors related to positive airway pressure therapy for post-TIA and stroke patients.

Matthias MS, Chumbler NR, Bravata DM, Yaggi HK, Ferguson J, Austin C, McClain V, Dallas MI, Couch CD, Burrus N, Miech EJ. Challenges and motivating factors related to positive airway pressure therapy for post-TIA and stroke patients. Behavioral sleep medicine. 2014 Mar 4; 12(2):143-57.

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Challenges adapting to continuous positive airway pressure (CPAP) therapy are largely unexplored in patients with stroke or transient ischemic attack. This study, nested within a randomized controlled trial of CPAP use, employed qualitative methods to explore challenges and motivators related to CPAP at two time points: prior to initiating therapy and at a 1-month follow up. Emergent thematic analysis, an inductive, qualitative approach, revealed variations in how patients experienced and adapted to CPAP across five phases: (a) interpreting the sleep apnea diagnosis, (b) contemplating CPAP therapy, (c) trying CPAP therapy, (d) making mid-course adjustments, and (e) experiencing benefits from CPAP therapy. Patients all had mild to moderate sleep apnea, and frequently did not experience sleep apnea symptoms. A salient motivator for adhering to CPAP therapy for these patients was the desire to reduce the risk of subsequent cerebrovascular events. Self-determination theory guided the interpretation of results.

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