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This randomized trial evaluated whether a structured group cognitive-behavioral intervention could improve CPAP uptake and adherence in people newly diagnosed with obstructive sleep apnea. Participants received treatment as usual or treatment as usual plus two one-hour cognitive-behavioral sessions that incorporated education and experiences from actual CPAP users. At 28 days, the intervention group used CPAP for more hours and was more likely to initiate treatment. Measures of self-efficacy and social support also improved, suggesting that behavior and confidence can influence whether patients persist with therapy. The study is clinically useful because it demonstrates that CPAP adherence is not purely a device problem. Patient beliefs, expectations, support and early experience all matter. This aligns closely with the NAPCON sleep symposium's message that CPAP adherence begins with counseling. The findings also help explain why a single educational message may be insufficient for some patients. In practice, clinicians can consider structured, repeated support, early troubleshooting and reinforcement of self-efficacy, particularly in patients who are hesitant or struggling during the first weeks of treatment.

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This randomized trial evaluated whether a structured group cognitive-behavioral intervention could improve CPAP uptake and adherence in people newly diagnosed with obstructive sleep apnea. Participants received treatment as usual or treatment as usual plus two one-hour cognitive-behavioral sessions that incorporated education and experiences from actual CPAP users. At 28 days, the intervention group used CPAP for more hours and was more likely to initiate treatment. Measures of self-efficacy and social support also improved, suggesting that behavior and confidence can influence whether patients persist with therapy. The study is clinically useful because it demonstrates that CPAP adherence is not purely a device problem. Patient beliefs, expectations, support and early experience all matter. This aligns closely with the NAPCON sleep symposium's message that CPAP adherence begins with counseling. The findings also help explain why a single educational message may be insufficient for some patients. In practice, clinicians can consider structured, repeated support, early troubleshooting and reinforcement of self-efficacy, particularly in patients who are hesitant or struggling during the first weeks of treatment.
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