0402 Factors associated with subjective sleep problem and treatment willingness in sleep clinic patients

Abstract

Abstract Introduction Insomnia clinic physicians often encounter patients with discrepancy between subjective and objective sleep problem. This study aimed to investigate factors that attributed to patients’ perception of sleep disturbances and treatment willingness, which were practical in determining diagnostic and treatment direction. Methods This study was a cross-sectional study, data collected from November 2018 to October 2022 in sleep clinic of tertiary university-affiliated hospital. Adults older than 19 who underwent sleep questionnaires and polysomnography (PSG) were included (n=3,239). Demographic data and sleep-related factors (alcohol, caffeine, exercise, education, job, marital status, comorbidity) were collected. Subjects were categorized into four groups by questionnaire answers (Do you think you have sleep problem? Do you want treatment for sleep problem? -group 1, neither; group 2, no sleep problem but want treatment; group 3, yes sleep problem without treatment willing; group 4, both yes.) and compared. Results Group 2 had higher percentage of job, snoring, witnessed apnea, worry about sleep, sleep maintenance problem than group 1. Group 3 had less job, sleep maintenance problem, daytime dysfunction, worry about sleep than group 4 (p< 0.05). Majority of no sleep problem groups were revealed to be normal (group 1: 28.0%, 2: 28.5%) or OSA (group 1: 63,7%, 2: 63.1%), while yes sleep problem groups were relatively higher combined insomnia and OSA (COMISA) (group 3: 20.0%, 4: 23.8%) or insomnia (group 3: 11.1%, 4: 15.3%) by PSG. OSA patients in group 2 showed more witnessed apnea and worry about sleep than group 1. COMISA patients in group 3 had less daytime dysfunction than group 4. However, PSG parameters were not significantly different among groups. Conclusion This study found that social need and subjective sleep maintenance problem are key factors that lead patients to regard their sleep as problematic or seek for treatment. In particular, patients with suspected OSA need to be instructed to get sleep study since sleep apnea severity do not affect treatment willingness and they had the lowest insight of their sleep problem. For those complaining of no or mild problem yet seeks for treatment, focusing on relieving misperceived worries about sleep is needed. Support (if any)