Improving sleep apnea treatment adherence after traumatic brain injury: A nonrandomized feasibility study.
Marc A Silva, Nora B Arriola, Chad K Radwan and 5 others
PMID 36355639WHAT IT FOUND
Thirteen of seventeen veterans with brain injury and sleep apnea completed a four-module telehealth program to improve CPAP use.
Retention and therapeutic alliance were high. Sleepiness and fatigue scores did not change significantly. The study tested feasibility, not whether the treatment works.
Key findings
01Thirteen of seventeen enrolled participants completed the intervention, with high therapeutic alliance scores reported throughout.
02Statistically significant changes were found only in increased OSA risk perception and decreased treatment barriers; fatigue, sleepiness, and functional impact did not change significantly.
03Self-reported PAP usage increased over time by approximately 1 hour per night and 1 day per week, though this was not the primary aim.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was not powered to detect efficacy and did not include a control group, so any observed changes cannot be attributed to the intervention. PAP adherence was self-reported rather than objectively measured, which typically underestimates actual usage. The sample was limited to male veterans with TBI seen in a rehabilitation setting, restricting generalizability. Attrition occurred, and those who withdrew had different baseline characteristics (less severe symptoms, more severe disability) than those who completed, though this was not statistically examined. The study did not formally collect data on harms, although no adverse events were reported.
The easy way to misread this
Do not interpret the improvements in risk perception or self-reported PAP use as evidence that this intervention effectively treats sleep apnea or improves health outcomes in patients with TBI. The study was a feasibility trial without a control group, and the primary clinical outcomes of fatigue and sleepiness did not show significant change.