Adherence to prescribed overnight sleep study in patients suspected of sleep apnea: problem size and influential factors
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SLEEP BREATHING PHYSIOLOGY AND DISORDERS • ORIGINAL ARTICLE
Adherence to prescribed overnight sleep study in patients suspected of sleep apnea: problem size and influential factors Shokoufeh Aalaei 1 & Mahnaz Amini 2 Hadi Asadpour 6 & Saeid Eslami 1,7,8
&
Ali Taghipour 3 & Lahya Afsharisaleh 4 & Fariborz Rezaeitalab 5 &
Received: 4 June 2020 / Revised: 27 September 2020 / Accepted: 6 October 2020 # Springer Nature Switzerland AG 2020
Abstract Purpose Despite the serious consequences of sleep apnea, some patients do not follow their physicians’ advice to undergo a sleep study. The present study aimed to determine the rate of adherence and influencing factors in conducting a polysomnography test in patients suspected of obstructive sleep apnea. Methods This qualitative and quantitative analysis was conducted between July 2017 and November 2019 on patients suspected of sleep apnea. The quantitative analysis aimed at determining the rate of adherence through a retrospective cross-sectional study. The qualitative content analysis was conducted on purposefully selected subgroup of patients suspected of obstructive sleep apnea who were referred for polysomnography. The required data were collected through the semi-structured in-depth interviews and then recorded, transcribed, and analyzed using SPSS.22 and MAXQDA10. Results Quantitative part: Of 311 patients (mean age: 47.6 ± 13.1 years) referred for polysomnography, 283 patients (91%) were at a high risk of developing obstructive sleep apnea. Among those referred for polysomnography, 31% (n = 95) adhered to recommendations for a sleep study. Qualitative part: Factors affecting adherence to polysomnography were categorized as “barriers” and “triggers.” Barriers included inadequate knowledge, psychological factors, cost, and the service system. Triggers included adequate knowledge and tangible experience of consequences of the illness. Conclusion The majority of patients at risk of developing obstructive sleep apnea did not follow the recommendation for polysomnography, indicating a need for systematic interventions. Among the identified barriers, knowledge and psychological factors are modifiable ones that can be addressed with the patient. We theorize that raising awareness among patients by providing additional information and eliminating concerns may help to increase the rate of adherence. Insurance coverage or subsidy to reduce the sleep study costs may also be an effective strategy to increase adherence to recommendations for polysomnography. Keywords Obstructive sleep apnea . Sleep study . Polysomnography . Patient education . Adherence
Introduction Obstructive sleep apnea (OSA) is a widely prevalent sleep disorder caused by the collapse of the upper airway soft * Mahnaz Amini [email protected] 1
2
3
Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Lung Diseases Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran Health Sciences researches Center,
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