Table 1 Session content

1

• Program overview: Impact of OSA on the patient and partner, what to expect in the sessions, treatment goals.

• Assessment: Main symptoms/sleep challenges, current sleep routine, goals (individual and couple-focused)

• Education: Background about sleep apnea and PAP, common problems with PAP, couple collaboration for troubleshooting PAP issues, communicating about PAP problems

• Homework: Review goals, reminder to complete sleep diaries

2

• Review homework: Review goals, homework, sleep diaries, and PAP download; discuss and strategize any PAP problems

• Sleep health: Defining sleep health and techniques for improving sleep health based on BBTI (consistent wake-time, stimulus control, sleep compression (as appropriate), sleep hygiene

• Homework: Set action plan for sleep health improvement, complete sleep diaries

3

• Review homework: Review sleep diaries and PAP download, strategize any PAP problems.

• Sleep health: Adjusting the sleep schedule (increase or decrease sleep opportunity window based on sleep efficiency)

• Evening routines: Discuss the role of hyperarousal/stress in contributing to sleep disturbance, both in general and specific to PAP anxiety; delivery of relaxation techniques including: establishing a wind-down together and PAP desensitization