Background: Continuous positive airway pressure is an effective treatment of obstructive sleep apnea syndrome, but adherenceto treatment is low. Interventions such as encouragement, education and cognitive behavioural therapy have affected adherenceto continuous positive airway pressure treatment positively. Currently there are no studies regarding the situation for personnelduring the initiation process of treatment.

Purpose: The purpose was to describe situations influencing the initiation of continuous positive airway pressure in patientswith obstructive sleep apnea syndrome from a personnel perspective.

Materials and methods: A qualitative approach using critical incident technique was used. Data were collected through semistructuredinterviews. Thirty one informants were strategically selected from sixteen centres in Sweden.

Results: Motivation, a prepared patient, communicational aspects and participation of family were described as pedagogicalcircumstances. External conditions, practical experience, the patient’s state of health and adaption to the mask were describedas practical circumstances. The personnel handled the situations in a theoretical, practical and/or an emotional way.

Conclusions: A better understanding of situations creating barriers or being facilitators, as well as ways to handle these situations,can be used to develop the role of personnel during the initiation process in order to increase continuous positive airwaypressure adherence.