In-office communication about excessive daytime sleepiness associated with treated obstructive sleep apnea: insights from an ethnographic study of physician-patient visits
Abstract Background Excessive daytime sleepiness (EDS), a primary symptom of obstructive sleep apnea (OSA), negatively affects functioning and quality of life (QoL). EDS can persist despite primary airway therapy, and often remains unmanaged, potentially due to inadequate provider-patient communicat...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | Sleep Science and Practice |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41606-022-00072-y |
| _version_ | 1818213415439564800 |
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| author | Christine Won Richard K. Bogan Karl Doghramji Joseph Ojile Shay Bujanover Danielle L. Hyman Kathleen A. Hewett Robert Thomas |
| author_facet | Christine Won Richard K. Bogan Karl Doghramji Joseph Ojile Shay Bujanover Danielle L. Hyman Kathleen A. Hewett Robert Thomas |
| author_sort | Christine Won |
| collection | DOAJ |
| description | Abstract Background Excessive daytime sleepiness (EDS), a primary symptom of obstructive sleep apnea (OSA), negatively affects functioning and quality of life (QoL). EDS can persist despite primary airway therapy, and often remains unmanaged, potentially due to inadequate provider-patient communication. Ethnographic research was conducted to assess provider-patient communication about EDS. Methods Participating physicians (primary care n = 5; pulmonologists n = 5; sleep specialists n = 3) identified adult patients (n = 33) diagnosed with OSA who were prescribed positive airway pressure (PAP) therapy ≥6 months prior and previously reported EDS. Visits and post-visit interviews were video-recorded and analyzed using standardized, validated sociolinguistic techniques. Results Despite 55% of patients (18/33) reporting QoL impacts post-visit, this was discussed during 28% (5/18) of visits. Epworth Sleepiness Scale was administered during 27% (9/33) of visits. Many patients (58% [19/33]) attributed EDS to factors other than OSA. Physicians provided EDS education during 24% of visits (8/33). Prior to the visit, 30% (10/33) of patients were prescribed EDS medication, of which 70% (7/10) reported currently experiencing EDS symptoms. Conclusions EDS was minimally discussed and rarely reassessed or treated after PAP therapy initiation in this study. Patients often attributed EDS to factors other than OSA. The findings suggest physicians and patients may benefit from dialogue tools, routine use of screening tools, and patient education. |
| first_indexed | 2024-12-12T06:03:56Z |
| format | Article |
| id | doaj.art-124b0178f2f54a45aad5f0a546485161 |
| institution | Directory Open Access Journal |
| issn | 2398-2683 |
| language | English |
| last_indexed | 2024-12-12T06:03:56Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Sleep Science and Practice |
| spelling | doaj.art-124b0178f2f54a45aad5f0a5464851612022-12-22T00:35:19ZengBMCSleep Science and Practice2398-26832022-05-01611910.1186/s41606-022-00072-yIn-office communication about excessive daytime sleepiness associated with treated obstructive sleep apnea: insights from an ethnographic study of physician-patient visitsChristine Won0Richard K. Bogan1Karl Doghramji2Joseph Ojile3Shay Bujanover4Danielle L. Hyman5Kathleen A. Hewett6Robert Thomas7Yale School of MedicineSleepMed, Inc.Thomas Jefferson UniversitySaint Louis University School of MedicineJazz Pharmaceuticals PLCJazz Pharmaceuticals PLCOgilvy HealthBeth Israel Deaconess Medical CenterAbstract Background Excessive daytime sleepiness (EDS), a primary symptom of obstructive sleep apnea (OSA), negatively affects functioning and quality of life (QoL). EDS can persist despite primary airway therapy, and often remains unmanaged, potentially due to inadequate provider-patient communication. Ethnographic research was conducted to assess provider-patient communication about EDS. Methods Participating physicians (primary care n = 5; pulmonologists n = 5; sleep specialists n = 3) identified adult patients (n = 33) diagnosed with OSA who were prescribed positive airway pressure (PAP) therapy ≥6 months prior and previously reported EDS. Visits and post-visit interviews were video-recorded and analyzed using standardized, validated sociolinguistic techniques. Results Despite 55% of patients (18/33) reporting QoL impacts post-visit, this was discussed during 28% (5/18) of visits. Epworth Sleepiness Scale was administered during 27% (9/33) of visits. Many patients (58% [19/33]) attributed EDS to factors other than OSA. Physicians provided EDS education during 24% of visits (8/33). Prior to the visit, 30% (10/33) of patients were prescribed EDS medication, of which 70% (7/10) reported currently experiencing EDS symptoms. Conclusions EDS was minimally discussed and rarely reassessed or treated after PAP therapy initiation in this study. Patients often attributed EDS to factors other than OSA. The findings suggest physicians and patients may benefit from dialogue tools, routine use of screening tools, and patient education.https://doi.org/10.1186/s41606-022-00072-yExcessive daytime sleepinessHypersomnolencePhysician-patient communicationObstructive sleep apneaQualitative research |
| spellingShingle | Christine Won Richard K. Bogan Karl Doghramji Joseph Ojile Shay Bujanover Danielle L. Hyman Kathleen A. Hewett Robert Thomas In-office communication about excessive daytime sleepiness associated with treated obstructive sleep apnea: insights from an ethnographic study of physician-patient visits Sleep Science and Practice Excessive daytime sleepiness Hypersomnolence Physician-patient communication Obstructive sleep apnea Qualitative research |
| title | In-office communication about excessive daytime sleepiness associated with treated obstructive sleep apnea: insights from an ethnographic study of physician-patient visits |
| title_full | In-office communication about excessive daytime sleepiness associated with treated obstructive sleep apnea: insights from an ethnographic study of physician-patient visits |
| title_fullStr | In-office communication about excessive daytime sleepiness associated with treated obstructive sleep apnea: insights from an ethnographic study of physician-patient visits |
| title_full_unstemmed | In-office communication about excessive daytime sleepiness associated with treated obstructive sleep apnea: insights from an ethnographic study of physician-patient visits |
| title_short | In-office communication about excessive daytime sleepiness associated with treated obstructive sleep apnea: insights from an ethnographic study of physician-patient visits |
| title_sort | in office communication about excessive daytime sleepiness associated with treated obstructive sleep apnea insights from an ethnographic study of physician patient visits |
| topic | Excessive daytime sleepiness Hypersomnolence Physician-patient communication Obstructive sleep apnea Qualitative research |
| url | https://doi.org/10.1186/s41606-022-00072-y |
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