Cues to starting CPAP in obstructive sleep apnea: development and validation of the cues to CPAP Use Questionnaire

The reasons that a patient has to start treatment, their "Cues to Action", are important for determining subsequent health behaviors. Cues to action are an explicit component of the Health Belief Model of continuous positive airway pressure (CPAP) acceptance. At present, there is no scale available to measure this construct for individuals with obstructive sleep apnea (OSA). This paper aims to develop, validate, and describe responding patterns within a sample of patients with OSA to the Cues to CPAP Use Questionnaire (CCUQ).

Participants were 63 adult patients diagnosed with OSA who had never tried CPAP when initially recruited. The CCUQ was completed at 1 month after being prescribed CPAP.

Exploratory factor analysis (EFA) showed a 3-factor structure of the 9-item CCUQ, with "Health Cues", "Partner Cues", and "Health Professional Cues" subscales accounting for 59.91% of the total variance. The CCUQ demonstrated modest internal consistency and split-half reliability. The questionnaire is brief and user friendly, with readability at a seventh-grade level. The most frequently endorsed cues for starting CPAP were Health Professional Cues (prompting by the sleep physician) and Health Cues such as tiredness and concern about health outcomes.

This study validates a measure of an important motivational component of the Health Belief Model. Health Professional Cues and internal Health Cues were reported to be the most important prompts to commence CPAP by this patient sample.