0523 Disparities in Discussion of Sleep-related Breathing Disorders with a Physician

Abstract

Abstract Introduction Race, immigration status and healthcare access have known associations with sleep health in socially disadvantaged groups. The prevalence and severity of sleep disorders, such as obstructive sleep apnea (OSA) are higher among non-whites and underdiagnosed in socially disadvantaged groups. Associations between sleep health and country of birth have also been identified. Certain minority groups are known to be less likely to report symptoms of OSA or insomnia to a physician. It's therefore possible that propensity for sleep disorder self-report plays a role in disparities of sleep health in socially disadvantaged groups. To our knowledge the predictors of sleep disorder self-report have yet to be studied. We aim to assess the predictors of sleep disorder self-report and analyze for associations with race, immigration status and healthcare access. Methods We conducted a cross-sectional analysis of 9,163 adult (age >18) patients in the National Health and Nutrition Examination Survey 2017-2020 database who answered the sleep disorders questionnaire and had race, immigration status and healthcare access data. Any answer to “How often do you snort or stop breathing (during sleep)?” was used as a surrogate endpoint for symptoms of OSA. “Yes” to “Ever told a doctor that you had trouble sleeping?” was used as a surrogate endpoint for sleep disorder self-report. We analyzed this cohort for associations between demographic characteristics, symptoms of OSA and sleep disorder self-report with survey sampling weights in STATA 17.0. Results In patients with symptoms of OSA (24%), measures of limited healthcare access, such as lack of health insurance (OR=1.59, p=0.030), or lack of location routinely visited for healthcare needs (OR=1.77, p=0.024), predicted higher likelihood of sleep disorder symptom non-disclosure, after adjustment for sex, age, and BMI. Non-white race (OR=1.70, p< 0.001) and being an immigrant (OR=2.40, p< 0.001) predicted higher likelihood of sleep disorder symptom non-disclosure in patients without symptoms of OSA, but not in patients with symptoms of OSA, after adjustment for sex, age, and BMI. Conclusion Our findings indicate that patients with limited healthcare access should be considered more strongly for sleep health evaluation and that non-white and immigrant patients are less likely to discuss sleep health with a physician. Support (if any)