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. 2025 Feb 1;21(2):229-235.
doi: 10.5664/jcsm.11360.

Obstructive sleep apnea illness perception relative to other common chronic conditions

Tania Zamora  1 , Brandon Nokes  2   3 , Atul Malhotra  3 , Carl Stepnowsky  1   4
Affiliations

Obstructive sleep apnea illness perception relative to other common chronic conditions

Tania Zamora et al. J Clin Sleep Med. .

Abstract

Study objectives: Obstructive sleep apnea (OSA) is a common chronic medical condition that results in impaired daytime functioning. While the link between OSA and cardiovascular disease is important, there has been increasing recognition of the impact of OSA on daytime functioning and experience. Better insight into illness perceptions can help better understand how to initiate and maintain treatment.

Methods: Data from 2 OSA clinical trials were examined. The baseline respiratory event index was obtained from diagnostic sleep testing. The Brief Illness Perception Questionnaire assesses the cognitive and emotional representation of illness and was administered at baseline along with the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index.

Results: A total of 523 patients diagnosed with OSA were studied. The sample had a mean age of 51.1 ± 16.6, mean respiratory event index of 28.6 ± 17.9 events/h, and mean body mass index of 32.8 ± 15.5 kg/m2. The mean Brief Illness Perception Questionnaire total score at baseline was 43.3 ± 11.3. Brief Illness Perception Questionnaire scores were significantly correlated with sleepiness and sleep quality but not with respiratory event index. Relative to other common chronic conditions with major comorbidities, Brief Illness Perception Questionnaire scores for patients with OSA were higher on consequences, identity, concern, and emotional representation dimensions.

Conclusions: The study shows that veterans with OSA report elevated illness perceptions across several dimensions at levels as high, or higher, than other common chronic conditions. Implications for clinical practice are that it is important to ask patients about their understanding of illness across several dimensions to appreciate better patient needs and preferences.

Citation: Zamora T, Nokes B, Malhotra A, Stepnowsky C. Obstructive sleep apnea illness perception relative to other common chronic conditions. J Clin Sleep Med. 2025;21(2):229-235.

Keywords: chronic illness; illness perception; sleep apnea syndromes.

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Conflict of interest statement

All authors have seen and approved the manuscript. Institution where work was performed: Veterans Affairs San Diego Healthcare System, San Diego, CA. Tania Zamora declares the absence of financial support and conflict of interest. Brandon Nokes is supported by the Department of Veterans Affairs CSR&D CDA-2 IK2CX002524-01A2 and National Institutes of Health Loan Repayment Program. He declares an absence on conflict of interest. Atul Malhotra is funded by National Institutes of Health. He declares income related to medical education from Livanova, Eli Lilly, Zoll, and Powell Mansfield. ResMed provided a philanthropic donation to University of California, San Diego. Carl Stepnowsky declares the absence of financial support and conflict of interest. Data from NCT0191665 is reported in this manuscript. The views expressed in this manuscript represent those of the authors and do not necessarily reflect those of the Department of Veterans Affairs.

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