JMIR Publications

ABSTRACT

Obstructive sleep apnoea is a highly burdensome condition that predominantly affects adults and not only impairs daily functioning but also confers a heightened risk of adverse cardiovascular health, particularly among those who are poorly compliant with continuous positive airway pressure ventilation therapy. In the growing era of high population demand and rising complexity, greater efforts are needed at the individual level if outcomes are to improve in the future. Therefore, this literature review sought to explore the effect of patient education upon sleep quality and blood pressure as secondary effects of CPAP adherence in adults. A search for relevant literature was performed using MEDLINE, EMBASE and the Cochrane library. Articles were restricted to peer-review, English language and publication in the last 10 years. Articles were appraised using CASP, relevant data was extracted using systematic proformas and the outcomes were analysed using descriptive analysis and narrative synthesis. Nine studies were included in the first analysis where there was a highly significant association between education provision and CPAP adherence (MD=1.19 hours/night, Z=3.67, p=0.0002), than compared to usual care. The second analysis was informed from five studies and this showed a positive association between education and sleep quality, but the effect was marginally insignificant (MD=0.54, Z=1.89, p=0.06), than compared to usual care. Both analyses were not affected by inter-study heterogeneity (both p<0.01). Overall, this review showed that the provision of education with moderate to high intensity provides meaningful effects upon CPAP adherence and sleep quality. Narrative findings also revealed improvements in blood pressure and other health outcomes, which are supported by previous studies. Despite some limitations, care providers should be proactivity in education provision using a continuous approach through the disease course as this is likely to lead to improvements in outcomes. Finally, future research is needed in the form of a high-quality randomised trial to help explore the effects of education delivered through eHealth mediums.