Obstructive sleep apnea (OSA) is often underdiagnosed and untreated partially because only one-third of adults with symptoms of OSA talk to a healthcare provider (HCP) about their sleep. It is… Click to show full abstract
Obstructive sleep apnea (OSA) is often underdiagnosed and untreated partially because only one-third of adults with symptoms of OSA talk to a healthcare provider (HCP) about their sleep. It is unclear how sociodemographic and clinical factors may influence communication with HCPs regarding sleep difficulties in adults at risk for OSA. This analysis examined associations between sociodemographics, comorbidities, and OSA-related symptoms and reporting trouble sleeping to an HCP in adults at high risk for OSA. The sample comprised adults at high risk for OSA (STOP-Bang of >=5 or STOP >=2 + body mass index (BMI) >35 kg/m2 or male sex) from the 2015-2018 National Health and Nutrition Examination Survey (n=2009). Participants were asked, “Have you ever told a doctor or other health professional that you have trouble sleeping?” OSA-related symptoms included daytime sleepiness, fatigue, insomnia, nocturia, snoring, and snorting/gasping/breathing cessation during sleep. Weighted binomial logistic regression models were employed. Participants were middle aged (mean age = 53.21 years + 0.5), obese (mean BMI = 34.76 + 0.25 kg/m2), and primarily male (71.9%) and white (65.2%). Half of the sample (50.8%) never reported trouble sleeping to an HCP. Female sex, former smoking, and diabetes, obstructive lung disease, daytime sleepiness, insomnia, nocturia, and/or snorting/gasping/breathing cessation during sleep were associated with higher odds of reporting trouble sleeping to an HCP. Snoring was not a significant predictor. Mexican American and non-Hispanic Asian race, having less than a high school education, and male sex were associated with lower odds of reporting trouble sleeping to an HCP. Not reporting trouble sleeping to an HCP among adults at high risk for OSA is common. Differences in sex, race, education, smoking status, comorbidities, and OSA-related symptoms exist between whose who have and have not reported trouble sleeping to an HCP. Insomnia and snorting/gasping/breathing cessation during sleep were the strongest symptom-related factors associated with reporting trouble sleeping to an HCP. It is important for HCPs to ask all adults about sleep problems, recognizing that men, racial minorities, and persons with lower educational attainment may be less likely to initiate a conversation about trouble sleeping. None
               
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