Trial reportJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2025
Effect of self-viewing of sleep-apnoea videos on positive airway pressure adherence in moderate to severe obstructive sleep apnoea: a prospective, parallel-group, randomised controlled trial.
Trial report in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
Authors and funding
3 authors.
Funding
Abstract
backgroundAdherence to positive airway pressure (PAP) therapy in obstructive sleep apnoea (OSA) remains suboptimal. Previous cognitive behavioural therapy (CBT) has relied on passive education approaches and has yielded mixed results.
objectiveTo evaluate whether personalised video footage showing one's own sleep-disordered breathing events (Self-Viewing of Sleep Apnoea Videos, SVSV) improves PAP adherence.
methodsIn this randomised controlled trial, 228 treatment-naïve patients with moderate to severe OSA were assigned to either the SVSV or standard CBT-only (control) group. All participants received standard CBT before PAP initiation. The SVSV group additionally viewed video footage of apnoeas from their own diagnostic polysomnography. The primary outcome was good adherence, defined as ≥ 4 h of sleep per night on ≥ 70% of nights for 90 days. Secondary outcomes included the number of days with adequate use, mean daily usage time, and apnoea-hypopnoea index (AHI) during PAP.
resultsGood adherence was achieved in 89.5% of the SVSV and 78.1% of the control group (absolute difference, 11.4%; 95% confidence interval (CI), 1.94% to 20.86%). Compared with the control group, the SVSV group had more days with adequate usage (mean difference of 9.05 days; CI, 2.29 to 15.81) and longer daily usage (mean difference of 0.55 h; CI, 0.13 to 0.98). AHI during PAP therapy was similar between the two groups.
conclusionsThis study supports the clinical utility of patient-specific visual feedback to improve PAP adherence. SVSV-a simple, low-cost, and scalable strategy-resulted in a higher proportion of patients achieving good adherence and greater usage. 1. Current Knowledge/Study Rationale: Adherence to positive airway pressure therapy in obstructive sleep apnoea is often inadequate, limiting its therapeutic benefit. Previous educational approaches, including video-based cognitive behavioural therapy, have yielded inconsistent effects on adherence. 2. Study Impact: This prospective, randomised controlled trial shows that allowing patients to view video segments of their own sleep-disordered breathing events, extracted from diagnostic polysomnography, significantly improves positive airway pressure adherence. This personalised self-viewing intervention is simple, cost-effective, and easily integrated into existing clinical workflows, with particular value for underserved populations and individuals with limited health literacy.
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