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Delayed Diagnosis and Burden of Illness of Excessive Sleepiness Associated with Obstructive Sleep Apnea
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A3644 - Delayed Diagnosis and Burden of Illness of Excessive Sleepiness Associated with Obstructive Sleep Apnea
Author Block: L. T. Waldman1, S. Parthasarathy2, K. F. Villa3, M. Bron3, S. Bujanover3, M. Brod1; 1The Brod Group, San Marcos, CA, United States, 2University of Arizona, Tucson, AZ, United States, 3Jazz Pharmaceuticals, Palo Alto, CA, United States.
Rationale: Obstructive sleep apnea (OSA) is associated with excessive sleepiness (ES) which has the potential to significantly impair a patient’s quality of life (QOL) and may go undiagnosed. This research examined timing and reasons patients sought medical care for their ES and OSA symptoms, and the impact of ES on QOL.
Methods: Semi-structured two-hour focus groups, segmented by gender, were conducted with 42 participants who experienced ES with OSA in three U.S. cities. Transcripts were coded using qualitative analysis software and analyzed for content by theme using an adapted grounded theory approach common to qualitative research. Copernicus Group Independent Review Board, an independent central IRB, approved the study. Informed consent was obtained from all participants.
Results: Over half of the sample reported sleeping an average of at least seven hours a night (n=23, 55%), and nearly three-quarters (n=31, 74%) were currently receiving treatment for airway obstruction. Twenty-two participants (52%) reported experiencing OSA symptoms for at least one year, with an average of 11.4 years (median 8.0 years, range 1-37 years), before seeking medical attention. During this period, participants who experienced delays in seeking medical care (n=22) reported snoring (n=20, 91%) and ES (n=13, 59%) as the most frequent concerns. Several participants (N=7, 32%) had considered their symptoms to be “normal” rather than a sign of a serious medical condition. For the entire study sample (n=42), the primary reasons for ultimately seeking medical attention were due to input from their spouse/partner, another family member, or friend (n=21, 50%), the participant’s own concern about particular symptoms (n=7, 17%), and/or falling asleep while driving (n=5, 12%). Four participants (10%) reported being misdiagnosed prior to receiving their OSA diagnosis. QOL domains reported to currently be impacted by ES included: 1) physical health and functioning (n=40, 95%); 2) daily life functioning (n=39, 93%); 3) cognition (n=38, 90%); 4) social life/relationships (n=37, 88%); and 5) emotions (n=30, 71%).
Conclusions: The study findings suggest that patients may be unaware that symptoms they experience could indicate an OSA diagnosis requiring evaluation and treatment. Even following diagnosis, ES associated with OSA can continue to place substantial burden on patients with respect to both the range and severity of QOL impacts. Further research is needed to address diagnostic delays and unmet treatment needs for patients with ES associated with OSA.
Author Block: L. T. Waldman1, S. Parthasarathy2, K. F. Villa3, M. Bron3, S. Bujanover3, M. Brod1; 1The Brod Group, San Marcos, CA, United States, 2University of Arizona, Tucson, AZ, United States, 3Jazz Pharmaceuticals, Palo Alto, CA, United States.
Rationale: Obstructive sleep apnea (OSA) is associated with excessive sleepiness (ES) which has the potential to significantly impair a patient’s quality of life (QOL) and may go undiagnosed. This research examined timing and reasons patients sought medical care for their ES and OSA symptoms, and the impact of ES on QOL.
Methods: Semi-structured two-hour focus groups, segmented by gender, were conducted with 42 participants who experienced ES with OSA in three U.S. cities. Transcripts were coded using qualitative analysis software and analyzed for content by theme using an adapted grounded theory approach common to qualitative research. Copernicus Group Independent Review Board, an independent central IRB, approved the study. Informed consent was obtained from all participants.
Results: Over half of the sample reported sleeping an average of at least seven hours a night (n=23, 55%), and nearly three-quarters (n=31, 74%) were currently receiving treatment for airway obstruction. Twenty-two participants (52%) reported experiencing OSA symptoms for at least one year, with an average of 11.4 years (median 8.0 years, range 1-37 years), before seeking medical attention. During this period, participants who experienced delays in seeking medical care (n=22) reported snoring (n=20, 91%) and ES (n=13, 59%) as the most frequent concerns. Several participants (N=7, 32%) had considered their symptoms to be “normal” rather than a sign of a serious medical condition. For the entire study sample (n=42), the primary reasons for ultimately seeking medical attention were due to input from their spouse/partner, another family member, or friend (n=21, 50%), the participant’s own concern about particular symptoms (n=7, 17%), and/or falling asleep while driving (n=5, 12%). Four participants (10%) reported being misdiagnosed prior to receiving their OSA diagnosis. QOL domains reported to currently be impacted by ES included: 1) physical health and functioning (n=40, 95%); 2) daily life functioning (n=39, 93%); 3) cognition (n=38, 90%); 4) social life/relationships (n=37, 88%); and 5) emotions (n=30, 71%).
Conclusions: The study findings suggest that patients may be unaware that symptoms they experience could indicate an OSA diagnosis requiring evaluation and treatment. Even following diagnosis, ES associated with OSA can continue to place substantial burden on patients with respect to both the range and severity of QOL impacts. Further research is needed to address diagnostic delays and unmet treatment needs for patients with ES associated with OSA.
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