Adaptation needs of patients with obstructive sleep apnea during positive airway pressure therapy: a longitudinal qualitative study based on transition theory

Aim This qualitative study aimed to explore the evolution of adaptation needs among patients with moderate to severe obstructive sleep apnea (OSA) during the initial phase of positive airway pressure (PAP) therapy, guided by Transition Theory, to provide references for improving patients’ treatment adherence. Methods The study employed a longitudinal qualitative design, adopting Transition Theory as the analytical framework. Data were collected through three rounds of semi-structured interviews with 12 moderate-to-severe OSA participants newly starting PAP therapy, recruited from the Sleep Medicine Department of a tertiary hospital in Shandong from March to July 2026. The interview material was analyzed using Colaizzi's seven-step analytical approach. Results Three core themes and nine sub-themes were extracted. (1) Initial Transition Period (1 week of treatment): Dual needs for physical safety and cognitive guidance. (2) Adjustment Period (1 month of treatment): Needs to resolve practical conflicts and sustain treatment motivation. (3) Stabilization Period (3 months of treatment): Needs for treatment acceptance and role transformation. Conclusion This study shows that participants with OSA have a staged, dynamic adaptation process to PAP initial phase of therapy, supporting the applicability of Transition Theory in chronic disease management. Guided by this theory, healthcare professionals should provide phased continuous interventions matching participants’ core needs at each stage, so as to help patients get through the initial treatment period smoothly and optimize health outcomes.