Sleeping together: a pilot study of the effects of shared sleeping on adherence to CPAP treatment in obstructive sleep apnea.

OBJECTIVES: To examine the sleep of married couples, recorded together in the laboratory before and after the husband is treated with continuous positive airway pressure (CPAP) to control his obstructive sleep apnea (OSA). The purpose was to investigate how these data relate to shared sleeping when he is on CPAP and his adherence to this treatment.

METHODS: Following a split-night diagnosis of OSA with CPAP titration, 10 married men slept for 2 additional nights with their non-apneic wife while both were recorded. The first night included a standard baseline 12-channel clinical polysomnogram without treatment. Following 2 weeks of home CPAP, the couple returned for a second polysomnography night with the husband on CPAP. Both partners completed Epworth Sleepiness Scales and Sleep Apnea Quality of Life Interviews each lab night. During the intervening 2 weeks, sleep logs were completed daily noting if CPAP was used, the presence of snoring, and where and how well they slept. Adherence data from machine downloads were obtained after an average of 4.6 months.

RESULTS: The husbands' baseline sleep differed significantly from their wives on 6 of 7 sleep variables related to OSA and on Epworth Sleepiness Scale scores. Their sleep did not differ the second night, except for his lower percentage of slow wave sleep. Adherence to CPAP was unrelated to OSA severity but positively related to the number of nights the couple slept together during the 2 weeks of home CPAP. The frequency of sleeping together was negatively related to the wives' arousal frequency on laboratory nights.

CONCLUSION: Although CPAP controls a husband's sleep-related OSA symptoms, his treatment adherence is strongly related to his wife sharing the bed. Addressing the wife's sensitivity to arousals when bed sharing may improve the husband's treatment adherence.