From diagnosis to long-term management: the experiences of older New Zealanders with obstructive sleep apnoea
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Date
2018-06-28
DOI
Open Access Location
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Publisher
Royal New Zealand College of General Practitioners
Rights
© Royal New Zealand College of General Practitioners 2018
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
INTRODUCTION: In New Zealand (NZ), access to public sleep services is limited to people
deemed with the highest need. The prevalence of obstructive sleep apnoea (OSA) increases
with age, but the symptoms and the treatment pathway is expected to differ for older compared
to younger patients. This study explored the experience of older people regarding
diagnosis and treatment services for OSA in order to inform considerations required in primary
health and sleep services.
METHODS: Patients who were initiated on Continuous Positive Airway Pressure (CPAP) therapy
at the age of 65 years or older were invited to one of three 1.5-h focus group discussions.
In total, 16 patients attended; nine were accompanied by their spouse or partner. Discussions
were semi-structured and explored experiences with the OSA pathway, from diagnosis
through to long-term management.
RESULTS: Thematic analysis highlights the key symptoms of OSA. Patients’ experiences with
diagnostic and treatment services were generally positive. However, there was an overarching
need for greater knowledge and follow up regarding OSA and CPAP therapy. Most patients
were happy with CPAP treatment. Issues associated with long-term use, comfort and daily
management were highlighted, and strategies used to overcome them discussed.
DISCUSSION: Focus groups reported similar experiences, positively endorsing the health value
of OSA diagnosis and CPAP therapy. Mechanisms and resources are required at a primary
healthcare level in order to raise awareness around sleep and aging, OSA and CPAP. This
would aid earlier and more appropriate diagnosis and management of OSA and help overcome
some of the gaps identified in this study.
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Keywords
Aged, Aged, 80 and over, Comorbidity, Continuous Positive Airway Pressure, Female, Focus Groups, Humans, Male, New Zealand, Patient Compliance, Patient Satisfaction, Prevalence, Sleep Apnea, Obstructive, Socioeconomic Factors
Citation
J Prim Health Care, 2018, 10 (2), pp. 140 - 149