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However, adherence to CPAP therapy is a major challenge and poor compliance limits its efficacy. This study investigated the potential of aromatherapy, a noninvasive, cost-effective intervention, to improve CPAP adherence and enhance sleep quality in patients with OSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective observational pilot study was conducted in patients with obstructive sleep apnea who demonstrated poor CPAP adherence (&lt;\u200970% usage and\u2009&lt;\u20094\u00a0h\/night). Participants were exposed to lavender or cypress aroma oil during sleep. Pre- and post-intervention subjective sleep measures Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), and objective CPAP usage metrics were collected. Normally distributed variables were analyzed using paired t-tests, and non-normally distributed variables were analyzed using the Wilcoxon signed-rank test. Statistical significance was set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05. A post hoc power analysis was performed based on observed effect sizes for the primary outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight patients with OSA (mean age 53.5\u00a0years; 4 males, 4 females) participated in the study. Following 67\u00a0days of treatment, the median PSQI score significantly improved from 9.0 to 6.5 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), and the median ESS score decreased from 9.0 to 6.5 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). Additionally, CPAP for more than 4\u00a0h increased from 5.0% to 25.7% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028). The median usage duration improved from 149 to 231\u00a0min (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). No significant change in apnea hypopnea index (AHI) was observed during CPAP use, decreasing from 3.2 events\/h to 1.3 events\/h (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.226), which is consistent with the understanding that appropriately applied CPAP maintains effective control of respiratory events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Aromatic stimulation with essential oils shows promise in improving both CPAP adherence and sleep quality, offering a novel approach to enhance OSA treatment efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12906-025-05243-9","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T06:14:22Z","timestamp":1767939262000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of aromatic stimulation on CPAP adherence and sleep quality in patients with obstructive sleep apnea: a pilot study"],"prefix":"10.1186","volume":"26","author":[{"given":"Erina","family":"Ishimizu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayako","family":"Inoshita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yo","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takatoshi","family":"Kasai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiko","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"5243_CR1","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1378\/chest.94.1.9","volume":"94","author":"J He","year":"1988","unstructured":"He J, Kryger MH, Zorick FJ, Conway X, Roth T. 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This study was approved by the Ethics Committee of the Juntendo University Faculty of Medicine. The clinical trial number is E 18\u2013213.Informed consent was obtained from all participants involved in the study, and this study was approved by the Juntendo University Faculty of Medicine (E 18-213). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"66"}}