J Clin Sleep Med. 2025 Dec 22;22(1):7. doi: 10.1007/s44470-025-00019-x.
ABSTRACT
BACKGROUND: Adherence to positive airway pressure (PAP) therapy in obstructive sleep apnoea (OSA) remains suboptimal. Previous cognitive behavioural therapy (CBT) has relied on passive education approaches and has yielded mixed results.
OBJECTIVE: To evaluate whether personalised video footage showing one’s own sleep-disordered breathing events (Self-Viewing of Sleep Apnoea Videos, SVSV) improves PAP adherence.
METHODS: In this randomised controlled trial, 228 treatment-naïve patients with moderate to severe OSA were assigned to either the SVSV or standard CBT-only (control) group. All participants received standard CBT before PAP initiation. The SVSV group additionally viewed video footage of apnoeas from their own diagnostic polysomnography. The primary outcome was good adherence, defined as ≥ 4 h of sleep per night on ≥ 70% of nights for 90 days. Secondary outcomes included the number of days with adequate use, mean daily usage time, and apnoea-hypopnoea index (AHI) during PAP.
RESULTS: Good adherence was achieved in 89.5% of the SVSV and 78.1% of the control group (absolute difference, 11.4%; 95% confidence interval (CI), 1.94% to 20.86%). Compared with the control group, the SVSV group had more days with adequate usage (mean difference of 9.05 days; CI, 2.29 to 15.81) and longer daily usage (mean difference of 0.55 h; CI, 0.13 to 0.98). AHI during PAP therapy was similar between the two groups.
CONCLUSIONS: This study supports the clinical utility of patient-specific visual feedback to improve PAP adherence. SVSV-a simple, low-cost, and scalable strategy-resulted in a higher proportion of patients achieving good adherence and greater usage. 1. Current Knowledge/Study Rationale: Adherence to positive airway pressure therapy in obstructive sleep apnoea is often inadequate, limiting its therapeutic benefit. Previous educational approaches, including video-based cognitive behavioural therapy, have yielded inconsistent effects on adherence. 2. Study Impact: This prospective, randomised controlled trial shows that allowing patients to view video segments of their own sleep-disordered breathing events, extracted from diagnostic polysomnography, significantly improves positive airway pressure adherence. This personalised self-viewing intervention is simple, cost-effective, and easily integrated into existing clinical workflows, with particular value for underserved populations and individuals with limited health literacy.
PMID:41678091 | DOI:10.1007/s44470-025-00019-x
