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Western Journal of Nursing Research, Vol. 27, No. 3, 307-321 (2005)
DOI: 10.1177/0193945904273283

Claustrophobia and Adherence to CPAP Treatment

Eileen R. Chasens

School of Nursing, University of Pittsburgh

Allan I. Pack

University of Pennsylvania

Greg Maislin

University of Pennsylvania

David F. Dinges

Division of Sleep and Chronobiology, School of Medicine, University of Pennsylvania

Terri E. Weaver

University of Pennsylvania School of Nursing, Center for Sleep and Respiratory Neurobiology, School of Medicine, University of Pennsylvania

This study evaluated the effect of claustrophobia, an abnormal dread or fear of closed spaces, on adherence to continuous positive airway pressure (CPAP) therapy. The design was a secondary analysis of data from a prospective study of participants (N = 153) that completed 3 months of CPAP therapy from seven sleep disorders centers in the United States and Canada. A 15-item subscale adapted from the Fear and Avoidance Scale measured claustrophobic tendencies pre-CPAP treatment and again after 3 months. An overt monitor attached to the CPAP machines recorded mask-on CPAP adherence. There was a statistically significant difference in claustrophobia scores by adherence group (< 2 hours, 2 to < 5 hours, ≥ 5 hours) and time period (pre-CPAP and after 3 months CPAP). Poor CPAP adherence (< 2 hours per night)was more than two times higher in participants with a claustrophobia score ≥ 25. Identification of persons with increased claustrophobia tendencies and targeted interventions may increase adherence.

Key Words: claustrophobia • sleep apnea • adherence • CPAP • compliance


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T. E. Weaver and R. R. Grunstein
Adherence to Continuous Positive Airway Pressure Therapy: The Challenge to Effective Treatment
Proceedings of the ATS, February 15, 2008; 5(2): 173 - 178.
[Abstract] [Full Text] [PDF]