Protocol for Nuestro Sueño: A randomized trial of a couples-based intervention to improve PAP adherence and sleep health among Hispanic patients beginning positive airway pressure (PAP) and their partners.
Baron K, Alcántara C, et al. • Sleep medicine • 2026
Nuestro Sueño is a culturally adapted couples-based digital health intervention being tested in a randomized controlled pilot/feasibility trial to improve PAP adherence and sleep health among Hispanic patients newly diagnosed with OSA and their partners.
Key Findings
Background
Obstructive sleep apnea is more common among Hispanic individuals and contributes to risk for cardiometabolic diseases, dementia, and poor quality of life.
OSA disproportionately affects Hispanic individuals compared to the general population.
The condition is linked to cardiometabolic diseases, dementia, and reduced quality of life.
Hispanic patients are described as more likely to face challenges to obtaining diagnosis and treatment for OSA.
This health disparity motivates the development of culturally adapted interventions.
Methods
The study is designed as a two-arm, parallel group, single blind, randomized controlled pilot/feasibility trial comparing a novel culturally adapted intervention (Nuestro Sueño) to an information control (IC).
The trial is registered at ClinicalTrials.gov under NCT06649929.
Both arms receive usual follow-up care in addition to their assigned condition.
The design is described as a pilot/feasibility trial, with results intended to inform a subsequent fully adequately-powered clinical trial.
The study is single blind.
Methods
Nuestro Sueño is a culturally adapted dyadic behavioral intervention delivered via telehealth using a community health worker over 3 weekly sessions.
The intervention is based on a transdiagnostic model.
Content focuses on education about OSA and PAP, improving both partners' sleep quality, increasing partner support and communication, and couple-level goal-setting around sleep and PAP use.
Delivery is through a digital health program via telehealth.
A community health worker serves as the interventionist.
The intervention targets couples in which one partner is recently diagnosed with OSA.
Methods
The information control (IC) condition consists of standardized patient educational materials plus usual follow-up care.
The IC serves as the comparator arm in the two-arm trial.
Both groups receive the usual follow-up care in addition to their respective conditions.
No active behavioral components are included in the IC beyond educational materials.
Methods
The primary outcomes of the trial are feasibility and treatment satisfaction.
Assessments are completed pre-treatment and at 1 and 3 months after starting PAP.
The pilot/feasibility focus reflects the early-phase nature of the trial.
Results will be used to inform the design of a subsequent fully adequately-powered clinical trial.
Methods
Secondary outcomes include PAP adherence, sleep quality (both self-report and objective measures), and cognitive measures of memory, processing speed, and verbal fluency.
PAP adherence is measured as a secondary outcome comparing Nuestro Sueño to IC.
Sleep quality is assessed through both self-report and objective measures.
Cognitive outcomes assessed include memory, processing speed, and verbal fluency.
These secondary outcomes will help evaluate potential signals of efficacy for the subsequent larger trial.
Background
Culturally adapted interventions are described as promising for increasing treatment engagement among Hispanic patients with OSA.
The intervention incorporates cultural adaptation as a central design feature.
The rationale is that Hispanic patients face greater barriers to OSA diagnosis and treatment.
The authors suggest a successful trial could 'significantly advance current clinical practice in the treatment of OSA' and 'promote sleep health equity among Hispanic patients.'
What This Means
This paper describes the design and protocol of a clinical trial called 'Nuestro Sueño' (Our Dream), which is testing a new program to help Hispanic patients who have recently been diagnosed with obstructive sleep apnea (OSA) stick with their CPAP or PAP therapy. OSA is a condition where breathing repeatedly stops during sleep, and it is particularly common in Hispanic communities, where it is also less likely to be diagnosed and treated. The study involves both the patient and their romantic partner, recognizing that sleep and health behaviors are often shared and influenced within couples. The intervention consists of three weekly video sessions led by a community health worker, covering education about sleep apnea, ways to improve both partners' sleep, and strategies for communication and mutual support around PAP use.
The trial randomly assigns couples to either the Nuestro Sueño program or a control group that receives standard educational materials. The researchers are primarily measuring whether the study design is feasible and whether participants find the program acceptable and satisfying. They are also tracking PAP usage, sleep quality, and even cognitive outcomes like memory and processing speed at one and three months after starting PAP treatment. This is a pilot study, meaning it is designed to test whether the approach works well enough to justify a larger, more definitive trial in the future.
This research suggests that combining cultural adaptation, couple-level involvement, telehealth delivery, and community health workers may be a practical way to improve PAP adherence and overall sleep health in Hispanic communities. If the program proves feasible and effective, it could help address a meaningful health disparity, since Hispanic individuals face higher rates of OSA and greater obstacles to getting diagnosed and treated. The results of this pilot will directly shape the design of a future large-scale clinical trial.
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Baron K, Alcántara C, López I, Euler M, Baucom B, Bermudez B, et al.. (2026). Protocol for Nuestro Sueño: A randomized trial of a couples-based intervention to improve PAP adherence and sleep health among Hispanic patients beginning positive airway pressure (PAP) and their partners.. Sleep medicine. https://doi.org/10.1016/j.sleep.2026.109019