Breathing Easy Together: How Positive Airway Pressure Adherence Benefits Both Patients and Partners

Objectives: Emerging research highlights the interdependence of sleep within couples and the impact of sleep disorders on couples’ relationship quality; however, most sleep treatments are focused solely on the individual. WePAP is a dyadic, behavioral treatment to promote positive airway pressure (PAP) adherence in patients with obstructive sleep apnea (OSA) and sleep quality in both patients and partners. This analysis examines the impact of WePAP compared to Information Control (IC) on the couples’ relationship quality. Across treatment conditions, we examined whether greater PAP adherence associates with better sleep and relationship quality, higher quality of life (QOL) and lower depression in both patients and partners. Methods: Patients who were diagnosed with OSA and prescribed PAP and their partners were randomly assigned to WePAP or information control (IC). Relationship quality (satisfaction and conflict), QOL, and depression were assessed in both partners via validated questionnaires at baseline and at 3-months. Sleep duration and efficiency were assessed via one-week of actigraphy in both partners. Primary analyses evaluated changes over time and between-group differences in relationship quality, from baseline to 3-month follow-up. Secondary analyses employed mixed models to assess whether greater patient PAP adherence predicts better relationship quality, mental health, and QoL, and greater sleep duration and efficiency. Results: The analytic sample included 32 midlife and older adult couples (age m=62.97; SD=9.04). There were no significant within-group or between-group changes in relationship satisfaction or conflict in patients or partners. Greater PAP adherence was associated with higher levels of relationship satisfaction and QOL and lower levels of relationship conflict and depressive symptoms, and shorter sleep duration for patients and partners. Conclusions: Identifying the dyadic effects of sleep apnea treatment on both partners’ wellbeing may serve as a compelling motivator to encourage adherence to PAP therapy.