Using short video-based educational intervention to enhance initial acceptance to continuous positive pressure therapy in Thai obstructive sleep apnea patients in a tertiary care: a randomized controlled trial.

Purpose: Obstructive sleep apnea (OSA) is a prevalent condition associated with decreased quality of life and increased risk of cardiovascular complications. Continuous positive airway pressure (CPAP) therapy is the gold standard treatment, particularly in moderate to severe OSA. Its effectiveness depends on patient adherence, with compliance rates ranging from 46 to 83%. Various strategies, including education, cognitive behavioral therapy, and supportive care, aim to improve CPAP adherence. This study evaluated the effectiveness of a low-cost, time-efficient video-based educational intervention to enhance CPAP compliance.

Methods: Patients diagnosed with moderate to severe OSA or mild OSA who fulfilled the indication for CPAP therapy in Siriraj Hospital between December 1st, 2022, and May 31st, 2023, age ≥ 18 years, were randomized into the three-minute video intervention group, based on Albert Bandura's social cognitive theory, and usual care group using a simple random sampling method. Demographics, Epworth Sleepiness Scale scores (ESS), polysomnographic data, and CPAP usage were recorded.

Results: Of the 132 subjects in this study, the majority were male, with an average age of 50 and comparable body mass index (BMI) and baseline ESS in both groups. We found a significantly higher percentage meeting the Centers for Medicare & Medicaid Services (CMS) criteria for adherence in the video education group (68.2%, vs. 50%; p = 0.034) compared to the usual care group. Moreover, in our post-hoc analysis, higher education years and lower BMI were associated with better CPAP adherence.

Conclusion: Our data demonstrated a promising result of using a short-formed video education intervention to enhance CPAP usage in OSA patients. Longer-term studies with a larger population would provide more reliable outcomes. This trial was retrospectively registered with Thaiclinicaltrials.org. The trial registration number (TRN) was TCTR20240619006, and the registration date is 18 June 2024.