Health and Wellness Coaching Can Improve Usage of Positive Airway Pressure Therapy in Participants With Obstructive Sleep Apnea and Obesity

Michelle Alencar; Rachel Sauls; Kelly Johnson; Shreya Thakkar; Anthony Carmona; Aaron Morse; Sirish Nakka

doi:10.1177/15598276241244719

Health and Wellness Coaching Can Improve Usage of Positive Airway Pressure Therapy in Participants With Obstructive Sleep Apnea and Obesity

Am J Lifestyle Med. 2024 Apr 9:15598276241244719. doi: 10.1177/15598276241244719. Online ahead of print.

Authors

Michelle Alencar^{1

2}, Rachel Sauls^{2

3}, Kelly Johnson^{2

4}, Shreya Thakkar², Anthony Carmona^{2

5}, Aaron Morse⁶, Sirish Nakka⁶

Affiliations

¹ Department of Kinesiology, California State University Long Beach, Long Beach, CA, USA (MA).
² InHealth Medical Services, Inc., Los Angeles, CA, USA (MA, RS, KJ, ST, AC).
³ College of Public Health, University of South Florida, Tampa, FL, USA (RS).
⁴ Department of Kinesiology, Coastal Carolina University, Conway, SC, USA (KJ).
⁵ College of Arts and Sciences, University of South Florida, Tampa, FL, USA (AC).
⁶ Sleep Health MD, Santa Cruz, CA, USA (AM, SN).

Abstract

Obstructive sleep apnea (OSA) has been tied to chronic conditions, such as obesity. Although continuous positive airway pressure (CPAP) device is an effective treatment, device discomfort impacts treatment adherence. Health and wellness coaching (HWC) can increase weight loss (WL) and adherence across other treatment types. This study aims to determine whether participants undergoing an HWC program improve CPAP device usage and WL compared to control group (CG). Participants were randomly selected to participate in the HWC group in conjunction with standard care. The HWC participants were gender, age, weight, CPAP usage (e.g., hours, days), and race matched to CG participants receiving standard care only. Variables collected include demographics (i.e., age, gender), CPAP device usage, and weight across four time points (baseline, 3-, 6-, and 9-months). Paired samples t-test and Pearson's coefficient correlation were conducted to determine how outcomes differ between groups. Of 232 participants studied, those in the HWC group significantly increased CPAP usage over time (P < .001) vs CG (6.5 ± 1.8, and 5.0 ± 2.3 hours, respectively). The HWC group had significantly more weight loss (11.0 ± 14.5 lbs.) than CG (5.7 ± 16.1 lbs.) across the 9-month timeline (P < .001). This study provides evidence that HWC can improve CPAP adherence and weight loss.

Keywords: adherence; health and wellness coaching; sleep; sleep apnea; weight loss.