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Table 1. Obstacles to CPAP Compliance
Physical Side Effects
- oronasal symptoms (congestion, stuffiness, dryness, nosebleeds, allergic rhinitis, sneezing, sinusitis, dry throat, cough)
- eye or ear pain
- headaches
- air swallowing/bloating
- skin irritation or ulceration
- frequent awakenings
Mechanical Problems
- improper mask fit/air leaks
- mask discomfort
- intolerance of CPAP pressure
- noise
- difficulty applying CPAP mask
- difficulty operating CPAP machine
Social Issues
- cost
- inconvenience
- lack of family support
- intolerance of CPAP by bed partner
- embarrassment
- travel
Psychological Factors
- panic reactions (claustrophobia, fear of suffocation, sense of being trapped)
- depression or other mental health issues
- lack of perceived benefit
Table 2. Ten Tips for Enhancing Patient Education12-14
1. Provide information in a variety of formats (verbal instructions, videotape, brochures) to promote comprehension and retention.
2. Don't give too much information at once; focus on necessary aspects of the treatment plan and give the patient time to digest information.
3. Simplify instructions if possible, making them specific, concrete and clear.
4. Organize or categorize information in a format that is easy to follow.
5. Avoid using medical terminology that may be misunderstood.
6. Repeat critical information, stressing the importance of compliance and the consequences of noncompliance.
7. Ask patients to repeat instructions or information to assess their understanding.
8. Anticipate side effects in advance and discuss their management.
9. Listen and respond to patients' questions and concerns.
10. Encourage patients to discuss barriers to treatment and how these might be addressed.
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