Abstract
This study aimed to explore the lived experiences of patients with Obstructive Sleep Apnea (OSA) and their bed partners as they adapted to Continuous Positive Airway Pressure (CPAP), focusing on the psychological, relational, and experiential processes influencing adherence over time. Semi-structured interviews were conducted with 12 OSA patients and their bed partners, purposefully sampled across three adaptation phases: before starting CPAP, within the first year of use, and after more than one year. Patients also completed the Epworth Sleepiness Scale(ESS) to provide a standardized measure of daytime sleepiness, complementing the qualitative findings. Semi-structured interviews were analyzed according to a Multi-Perspective Interpretative Phenomenological Analysis (MP-IPA) approach, which allowed for the identification of both individual and dyadic meaning-making processes. Three superordinate themes emerged: Making Sense of the Illness, Living the Illness Together, and From CPAP Resistance to Acceptance. Findings illustrate the evolving nature of illness representations, the central but ambivalent role of the partner in facilitating care, and the relational dynamics shaping CPAP engagement. While patients gradually integrated CPAP into their self-management, partners transitioned from active promoters to quieter sources of emotional and practical support. Dyadic tensions, divergent illness perceptions, and shifting motivations influenced the trajectory of adaptation. Results from the ESS indicated that patients with long-term CPAP use reported normalized sleepiness, whereas those in earlier stages experienced clinically significant daytime drowsiness. CPAP adaptation is thus a dynamic, relational process influenced by how both patients and partners conceptualize the illness and navigate the challenges of therapy. Partner involvement plays a key role but must balance support with respect for patient autonomy. Interventions aimed at enhancing adherence should consider the couple as a unit, integrating psychoeducational and relational components. Future research should expand on these findings using larger, more diverse samples and evaluate the impact of tailored interventions and telemedicine in long-term CPAP management. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-025-30682-2.