{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:28:59Z","timestamp":1786548539643,"version":"build-2736575974"},"reference-count":85,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T00:00:00Z","timestamp":1562112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Continuous positive airway pressure (CPAP) is highly effective in treating sleep\u2010disordered breathing (SDB). However, unlike surgical interventions, this treatment modality relies heavily on patient acceptance and adherence. The current definition of adherence is largely arbitrary and is mainly used by third\u2010party payers to determine CPAP reimbursement but CPAP adherence remains sub\u2010optimal. Strategies to augment adherence, especially early in the course of a CPAP trial, are needed in the management of SDB. An understanding of the basis for observed differences in CPAP and oral appliance (OA) use is necessary in developing these strategies, but to date no single factor has been consistently identified. Consequently, a multidimensional approach using educational, behavioural, technological and potentially pharmacological strategies to target (i) disease characteristics, (ii) patient characteristics including psychosocial factors, (iii) treatment protocols and (iv) technological devices and side effects that may influence adherence, is likely required to augment the complex behaviour of CPAP and OA use. In the near future, we envision a personalized medicine approach to determine the risk of non\u2010adherence and set individualized adherence goals aimed at treating specific symptoms (e.g. excessive daytime sleepiness) and reducing the risk of patient\u2010specific SDB consequences (e.g. atherosclerosis). Resources for interventions to improve adherence such as educational programmes and telemedicine encounters could then be more efficiently allocated.<\/jats:p>","DOI":"10.1111\/resp.13589","type":"journal-article","created":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T00:29:25Z","timestamp":1562200165000},"page":"363-371","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Strategies to augment adherence in the management of sleep\u2010disordered breathing"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8616-1053","authenticated-orcid":false,"given":"Bernie Y.","family":"Sunwoo","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Pulmonary Critical Care and Sleep Medicine, University of California  San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Light","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary Critical Care and Sleep Medicine, University of California  San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7021-9302","authenticated-orcid":false,"given":"Atul","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary Critical Care and Sleep Medicine, University of California  San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/30.6.711"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.1.111"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/147.4.887"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.149.1.8111574"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.2.2005037"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.2916"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2011.01.003"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200708-119MG"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2017.11.005"},{"key":"e_1_2_9_11_1","first-page":"320","article-title":"Early CPAP use identifies subsequent adherence to CPAP therapy","volume":"30","author":"Budhiraja R","year":"2007","journal-title":"Sleep"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/15.suppl_6.S42"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.4.9807111"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-015-1301-0"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.4858"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2004.04.002"},{"key":"e_1_2_9_17_1","first-page":"e72","article-title":"Oral appliance therapy in obstructive sleep apnea: long\u2010term adherence and patients experiences","volume":"23","author":"Saglam\u2010Aydinatay B","year":"2018","journal-title":"Med. Oral Patol. Oral Cir. Bucal"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","unstructured":"SchwabRJ BadrSM EpsteinLJ GayPC GozalD KohlerM LevyP MalhotraA PhillipsBA RosenIMet al.;ATS Subcommittee on CPAP Adherence Tracking Systems. An official American Thoracic Society statement: continuous positive airway pressure adherence tracking systems. The optimal monitoring strategies and outcome measures in adults.Am. J. Respir. Crit. Care Med.2013;188:613\u201320.","DOI":"10.1164\/rccm.201307-1282ST"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.103.6.1675"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12584"},{"key":"e_1_2_9_21_1","first-page":"1543","article-title":"Characterization of a tooth microphone coupled to an oral appliance device: a new system for monitoring OSA patients","volume":"2017","author":"Castillo Y","year":"2017","journal-title":"Conf. Proc. IEEE Eng. Med. Biol. Soc."},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/smrv.2001.0197"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0189614"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732310365502"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300060518758583"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-011-0537-6"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/psy.0b013e318068b2f7"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.1428"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.26800"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-860894"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2011.00969.x"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.1404"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/32.6.799"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2007.00620.x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-012-0788-x"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.4.9808008"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-010-0374-z"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/25.7.758"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/27.1.134"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/0193945904273283"},{"key":"e_1_2_9_41_1","doi-asserted-by":"crossref","unstructured":"EpsteinLJ KristoD StrolloPJJr FriedmanN MalhotraA PatilSP RamarK RogersR SchwabRJ WeaverEMet al.;Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine. Clinical guideline for the evaluation management and long\u2010term care of obstructive sleep apnea in adults.J. Clin. Sleep Med.2009;5:263\u201376.","DOI":"10.5664\/jcsm.27497"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2013.03.002"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2006.05.010"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-2228"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2017-210106"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2001-12789"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1080\/15402000701190549"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1080\/15402002.2016.1276018"},{"key":"e_1_2_9_49_1","first-page":"CD007736","article-title":"Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea","author":"Wozniak DR","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3118"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.07.110"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/30.5.635"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.56.7.513"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.5578"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/28.12.1554"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1159\/000089836"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240602000202"},{"key":"e_1_2_9_58_1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.14639\/0392-100X-1935","article-title":"Moderate OSAS and turbinate decongestion: surgical efficacy in improving the quality of life and compliance of CPAP using Epworth score and SNOT\u201020 score","volume":"38","author":"Fiorita A","year":"2018","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"e_1_2_9_59_1","first-page":"296","article-title":"Nasal resistance for determinant factor of nasal surgery in CPAP failure patients with obstructive sleep apnea syndrome","volume":"43","author":"Nakata S","year":"2005","journal-title":"Rhinology"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.27032"},{"key":"e_1_2_9_61_1","doi-asserted-by":"crossref","unstructured":"MorgenthalerTI AuroraRN BrownT ZakR AlessiC BoehleckeB ChessonALJr FriedmanL KapurV MagantiRet al.;Standards of Practice Committee of the AASM;American Academy of Sleep Medicine. Practice parameters for the use of autotitrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome: an update for 2007. An American Academy of Sleep Medicine report.Sleep2008;31:141\u20137.","DOI":"10.1093\/sleep\/31.1.141"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2010.02.003"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/27.2.249"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/27.8.1512"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.4.1112"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.2.430"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.5.1369"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-0811"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-10-200911170-00006"},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.2660"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usx038"},{"key":"e_1_2_9_72_1","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1097\/MCP.0b013e32834bdf6e","article-title":"Adherence\u2010based coverage of positive airway pressure treatment for sleep apnea: the 'brave new world' of cost\u2010saving strategies","volume":"17","author":"Brown LK","year":"2011","journal-title":"Curr. Opin. Pulm. Med."},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000132353.99209.fe"},{"key":"e_1_2_9_74_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201703-0582OC"},{"key":"e_1_2_9_75_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.133215"},{"key":"e_1_2_9_76_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9.2.e14"},{"key":"e_1_2_9_77_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01128-2016"},{"key":"e_1_2_9_78_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.4186"},{"key":"e_1_2_9_79_1","first-page":"CD005308","article-title":"Continuous positive airway pressure delivery interfaces for obstructive sleep apnoea","volume":"4","author":"Chai CL","year":"2006","journal-title":"Cochrane Database Syst. Rev."},{"key":"e_1_2_9_80_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.4.2151"},{"key":"e_1_2_9_81_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00035603"},{"key":"e_1_2_9_82_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.6.2085"},{"key":"e_1_2_9_83_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-008-0199-1"},{"key":"e_1_2_9_84_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-2646"},{"key":"e_1_2_9_85_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-2379"},{"key":"e_1_2_9_86_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.151.2.7842204"}],"container-title":["Respirology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/resp.13589","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/resp.13589","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/resp.13589","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T22:04:55Z","timestamp":1694037895000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/resp.13589"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,3]]},"references-count":85,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1111\/resp.13589"],"URL":"https:\/\/doi.org\/10.1111\/resp.13589","archive":["Portico"],"relation":{},"ISSN":["1323-7799","1440-1843"],"issn-type":[{"value":"1323-7799","type":"print"},{"value":"1440-1843","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,3]]},"assertion":[{"value":"2018-10-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}