Obstructive sleep apnea is a prevalent chronic sleep disorder within the Department of Veterans Affairs (VA) health care system, significantly influenced by patient engagement with prescribed therapies. A recent research letter, authored by Gwendolyn C. Carlson from the VA Greater Los Angeles Healthcare System and colleagues, including Jennifer L. Martin, was published on October 7, 2026, in the Journal of Clinical Sleep Medicine. This study uniquely focuses on the values expressed by women veterans as they begin treatment for sleep apnea, rather than solely assessing symptom severity or adherence rates.
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Obstructive sleep apnea leads to the repeated collapse of the upper airway during sleep, resulting in oxygen desaturation, disrupted sleep, daytime fatigue, and increased risks for cardiovascular and metabolic diseases. The standard treatment, continuous positive airway pressure (CPAP), involves using a mask that delivers pressurized air to the user, effectively managing the disorder when used consistently. However, research—including findings from a national study in Sweden—indicates that many patients struggle to maintain CPAP use, correlating treatment non-adherence with higher mortality rates. Past efforts to enhance CPAP utilization have yielded limited success, indicating that deeper understanding of the factors influencing patient behavior is needed.
Carlson and her team propose that personal values are a crucial, yet often overlooked, factor in treatment adherence. They apply principles from acceptance and commitment therapy—developed by Steven Hayes—to assess personal values, which encompass meaningful life goals such as health, parenting, and community engagement rather than abstract morals. By linking health behaviors to these values, patients may find greater purpose in adhering to treatment.
The researchers utilized psychometric tools from the acceptance and commitment therapy framework, including the Bull’s-Eye Values Survey and the Valued Living Questionnaire. These instruments help participants identify and prioritize areas of life that matter to them, providing a baseline for assessing adherence and quality of life outcomes before therapy begins.
Focusing on women veterans is deliberate as they represent the fastest-growing segment of the veteran population, yet have faced a historical oversight in sleep disorder research compared to their male counterparts. Symptoms in women can differ, often presenting as insomnia or fatigue instead of the classic snoring associated with men. Additionally, women veterans frequently juggle caregiving roles and employment alongside the mental and physical effects of military service, making it essential to understand their values for effective sleep apnea treatment design.
The study builds on earlier research regarding chronic insomnia by the same team, conducted as part of the VA's shift toward a Whole Health care model. This approach emphasizes individual patient values over a purely disease-focused treatment paradigm. The research is part of a registered clinical trial, NCT03377452, approved by the VA Greater Los Angeles Institutional Review Board, with consent obtained from participants.
The study's findings could inform broader practices in sleep clinics. If the values identified at treatment initiation help predict ongoing engagement with CPAP therapy, a values-based inventory could serve as an effective and low-cost screening tool to identify patients needing tailored support. This approach recognizes adherence as intertwined with personal meaning, which is vital for women veterans who may feel unheard in traditional health assessments. As systems aim for whole-person care, this research provides measurable steps toward enhancing patient-centered approaches in sleep medicine.