Application of a knowledge, attitude, belief, and practice model in CPAP treatment of patients with OSAHS

Continuous positive airway pressure (CPAP) is the first-line treatment for moderate to severe obstructive sleep apnea-hypopnea syndrome (OSAHS), but poor adherence limits its effectiveness. The Knowledge, Attitude, Belief, and Practice (KABP) model has shown promise in enhancing health behaviors, but its application in CPAP management remains unexplored.

To evaluate the efficacy of the KABP model in improving CPAP adherence and clinical outcomes in patients with OSAHS compared to traditional nursing interventions.

This retrospective case-control study included 147 patients (129 male) aged 32-69 years with moderate to severe OSAHS (AHI≥15/h) who who received CPAP treatment between January 2022 and April 2025 and were naïve to prior sleep disorder treatments. Patients were divided into a control group (n = 60) receiving conventional nursing and an experimental group (n = 87) receiving KABP-based interventions. Outcomes assessed included CPAP adherence, blood pressure control, changes in Apnea-Hypopnea Index (AHI), minimum oxygen saturation (MSAT), and Stage N3 sleep, anxiety levels (SAS scale), quality of life (SF-36), and nursing satisfaction.

The experimental group exhibited significantly higher percentage of nights with ≥4 h of CPAP (81.76 ± 14.72% vs. 57.94 ± 19.51%, p < 0.001), higher mean nightly CPAP use (6.31 ± 0.96 vs. 4.82 ± 1.16 h/night, p < 0.001) and lower dropout rates (3.45% vs.15.00%, p = 0.025) compared to the control group. AHI values, MSAT, Stage N3 sleep and ESS score improved significantly in the experimental group at 6 months post-CPAP initiation (p < 0.01). The experimental group demonstrated significantly greater reductions in systolic blood pressure (SBP: 15.35 ± 7.28 vs. -6.30 ± 4.33 mmHg, p < 0.001) and diastolic blood pressure (DBP: 13.31 ± 10.12 vs. -2.50 ± 4.89 mmHg, p < 0.001) at 6 months compared to the control group. Additionally, improvement in anxiety levels, quality of life scores and patient satisfaction was significantly higher in the experimental group (p < 0.001).

The application of the KABP model in CPAP treatment for OSAHS is associated with significantly improved patient adherence, clinical outcomes, psychological well-being, and overall satisfaction compared to traditional nursing interventions. While this retrospective study design limits causal inference, our findings suggest that the KABP model represents a potentially effective strategy for enhancing long-term CPAP adherence and quality of life in patients with OSAHS, supporting further investigation of its integration into routine clinical practice for sleep-disordered breathing management.