{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:34:13Z","timestamp":1787009653056,"version":"build-2736575974"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Study Objectives<\/jats:title>\n Despite the well-established benefits of positive airway pressure (PAP) therapy in obstructive sleep apnea (OSA), adoption and persistence rates vary widely. Self-efficacy, motivation and social support may be important behavioral determinants of PAP usage, but few studies have examined the role of these factors in real-world populations.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective analysis examined the association between behavioral survey data and objectively measured PAP usage data among PAP therapy users with OSA. A feature selection process helped identify key behavioral predictors of PAP usage, and Firth\u2019s logistic regression estimated the association between selected behavioral determinants and short-term (90 days) and long-term (360 days) PAP therapy usage. Regressions controlled for demographic and clinical factors, PAP device type, and length of therapy use.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 11,228 respondents were included in the 90-day assessment and 3,605 were included in the 360-day assessment. Confidence to stay on therapy, identification of a motivator, and involvement of a health care provider were significantly associated with greater odds of both short and long-term PAP usage. In males and females, confidence was a significant determinant of greater odds of PAP usage, but there were gender differences by the type of motivation and the importance of social support.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Confidence, motivation and healthcare provider involvement may play an important role in achieving both short- and long-term PAP therapy use. These insights, alongside the observed differences in behavioral drivers by gender, suggest an opportunity to better understand and tailor PAP follow-up strategies that leverage behavior change determinants.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/sleep\/zsaf208","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T11:54:39Z","timestamp":1753271679000},"source":"Crossref","is-referenced-by-count":4,"title":["The role of confidence, motivation, and social support in PAP usage in obstructive sleep apnea: A real-world data analysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5345-7026","authenticated-orcid":false,"given":"Leanne","family":"Kaye","sequence":"first","affiliation":[{"name":"Resmed Science Center , San Diego, CA \u00a0","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vy","family":"Vuong","sequence":"additional","affiliation":[{"name":"Resmed Science Center , San Diego, CA \u00a0","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith A","family":"Barrett","sequence":"additional","affiliation":[{"name":"Resmed Science Center , San Diego, CA \u00a0","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam V","family":"Benjafield","sequence":"additional","affiliation":[{"name":"Resmed Science Center , Sydney, NSW \u00a0","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7920-4924","authenticated-orcid":false,"given":"Peter A","family":"Cistulli","sequence":"additional","affiliation":[{"name":"Charles Perkins Centre, University of Sydney and Royal North Shore Hospital , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Malhotra","sequence":"additional","affiliation":[{"name":"University of California San Diego , La Jolla, California ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3832-2358","authenticated-orcid":false,"given":"Jean-Louis","family":"P\u00e9pin","sequence":"additional","affiliation":[{"name":"University of Grenoble Alpes, HP2 Laboratory, Inserm U1300 , Grenoble ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,23]]},"container-title":["Sleepj"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/sleep\/advance-article-pdf\/doi\/10.1093\/sleep\/zsaf208\/63831984\/zsaf208.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sleep\/advance-article-pdf\/doi\/10.1093\/sleep\/zsaf208\/63831984\/zsaf208.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T13:28:09Z","timestamp":1753277289000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/sleep\/advance-article\/doi\/10.1093\/sleep\/zsaf208\/8211003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,23]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/sleep\/zsaf208","relation":{},"ISSN":["0161-8105","1550-9109"],"issn-type":[{"value":"0161-8105","type":"print"},{"value":"1550-9109","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,23]]},"article-number":"zsaf208"}}