Amy Sawyer, Ph.D. | American Lung Association

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Amy Sawyer, Ph.D.

The Pennsylvania State University
Treating Claustrophobia in Sleep Apnea Patients Using Positive Airway Pressure

Sleep disordered breathing, such as sleep apnea, is commonly treated with positive airway pressure therapy (PAP), which requires patients to wear a mask worn snugly over the nose or mouth. Patients who do not adhere to the treatment have worsened health and quality of life. A common reason patients do not use PAP is claustrophobia. We will study an anxiety treatment called mindfulness-based stress reduction (MBSR) to determine its effect on claustrophobia. MSBR is a method of using meditation to cultivate awareness and reduce stress. We will determine the feasibility and patient acceptability of MBSR in PAP-treated adults with sleep apnea. We hope to reduce the burden of disease by promoting adherence to PAP through the reduction of claustrophobia.

Update: We established a new site at University of Pennsylvania Sleep Center, where mindfulness consultant support is available through the Mindfulness Program at Penn. We are recruiting and enrolling patients. The eight sessions of group mindfulness-based stress reduction intervention for claustrophobia (MBSR-C) will include instruction and practice in mindfulness meditation skills (body scanning, sitting meditation, breathing exercises, mask and CPAP exposure during mindfulness instruction) and discussion of self-awareness of thoughts, emotions and physical response to stress, coping, and weekly homework assignments. MBSR-C practice outside of formal sessions will be supported by weekly written instruction guides and recorded CDs/digital audio files that reinforce MBSR-C class content and serve as a home practice guide. Patients will fill out a diary weekly about their home MBSR-C practice. Claustrophobia and CPAP use will be assessed one week and one month after MBSR-C in addition to patients' diaries of mindfulness home practice after the completion of the program.

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