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By: AAST Associate Editor on March 12th, 2020

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CPAP Group Education: A Promising Method for Improved CPAP Adherence

CPAP | CPAP Adherance | Group Education

As sleep professionals, we know the importance of using a CPAP device to keep our patients’ breathing consistent while they sleep. For patients with compliance difficulties, CPAP group education might be a viable option. Evidence shows improving CPAP adherence with education in a peer-to-peer environment is an effective way to engage patients. These CPAP support groups and CPAP group discussions can be extremely beneficial for both the patient and the sleep technologist.


What is Group Education?

Group education occurs when individuals come together to learn, discuss and share information with each other in a face-to-face environment.  This can be facilitated both in person and via an internet-calling platform like Skype or Zoom.

Common types of group education settings include:

  • Workshops
  • Meetings
  • Classes
  • Small groups
  • Roundtables

The goal of group education is to provide an open forum for people to gather and learn. This idea is similar to small groups found in an education setting where“Group activities enable students to discover deeper meaning in the content and improve thinking skills.” These group settings can be supplemented using videos, questionnaires and one-on-one follow ups. In one study from Brazil, these add-ons resulted in increased compliance for patients using CPAP.

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The Benefits of CPAP Group Education

Group education allows for an individual to share their own thoughts, struggles, ideas and questions with others in the same situation. It can also alleviate the feeling of isolation, providing emotional support and understanding between patients. Allowing patients to discuss their treatment plans can help validate the treatment, as well as promote communication and positive support. According to a recent CPAP study by Drs. Christopher J. Lettieri and Robert J. Walter, group educational programs provided:

  • Increased access to care
  • Reduced individual resource allocation
  • An increased number of patients seen per unit of time
  • Improved CPAP adherence

Lettieri and Walter’s study found patient’s lack of adherence around CPAP circulated around a general misunderstanding of the adverse effects of untreated obstructive sleep apnea and proper use of a CPAP.  Allowing them to have access to the equipment—as well as participate in meaningful discussions about the therapeutic plan with one another and a member of their care team—greatly increased the outcomes of their CPAP usage.

While some may be concerned patients will not want to share their thoughts or will be too afraid to participate in a group discussion about CPAP, group education has proven to help CPAP users overall compared to those who attend individual sessions with a sleep specialist. According to this study, CPAP users who attended group education sessions:

  • Used a CPAP device for more nights
  • Used a CPAP device for a longer time period throughout the night
  • Discontinued therapy less frequently

Overall, this educational strategy resulted in improved acceptance of and adherence to CPAP therapy.  Further research will be needed to develop strategies that will help with improving the process of therapy initiation in a group setting.  Ongoing support in group settings is a critical element of successful therapy, and can make a big difference if instituted early on in CPAP therapy.  While these early results are showing positive benefits of group education, prospective randomized studies are needed to determine whether CPAP group education is an appropriate alternative to individual counseling. Moreover, the cost-effectiveness and efficiency of these programs needs further study to determine their overall effectiveness.

The Importance of Peer-to-Peer Education

As we move into group education settings, it is crucial to know the importance that peer-to-peer learning/education has on patients. This face to face interaction not only allows for multiple patients to learn at the same time, but for them to share their thoughts and ideas on an equal playing field. As mentioned in the module, peer-to-peer education allows for:

  • Patients to sit down next to each other and share their CPAP stories, struggles and improvements
  • Patients to get excited about sharing new ideas
  • Patients discuss CPAP products and talk about the different manufacturers’ equipment

This idea of peer-to-peer education is starting to catch on in national institutions and agencies, such as Veterans Affairs hospitals.  Professionals there are starting to use group set-ups and classes where there is peer-to-peer learning in a face-to-face setting.  In general, studies show group education is becoming more popular across the medical field. With education techniques and practices constantly changing, group education in the medical field is also continuously changing and more research is being done to find what works best for patients.

Some of the key observations of peer learning programs include:

  • Improved learning outcomes
  • Increased general awareness regarding treatment management
  • Improved understanding of procedures
  • Reduced overuse of health services
  • Increasing trust between patients and their care team

The biggest benefit, some argue, is that patients appear to relate better to others who have undergone the same type of care they have, and possibly buy into their therapy more after hearing perspectives from fellow patients. Experts say while group formats can be effective for things like CPAP adherence, it is also important for peer-led education to be supervised by a medical professional.



Group education for CPAP users is proven to be effective. While more research needs to be conducted to determine the best methods for group education, early conclusions point to group education being a key factor in better CPAP usage.


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Group education for CPAP users is proven to be effective. While more research needs to be conducted to determine the best methods for providing group education, early conclusions point to group education being a key factor in better CPAP usage.

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