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Persistent Obstructive Sleep Apnea Burden on Family Finances and Quality of Life
Mathieu Bergeron1,2, Stacey L Ishman1,3,4
1Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Insights
Families of children with obstructive sleep apnea (OSA) face significant financial burdens and toxicity. Missed work and school days due to appointments contribute to this financial strain.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Health Economics
Background:
- Persistent obstructive sleep apnea (OSA) in children negatively impacts family quality of life.
- Financial concerns are a significant stressor for families managing pediatric chronic conditions.
Purpose of the Study:
- To quantify the financial impact of persistent pediatric obstructive sleep apnea (OSA) on families.
- To identify factors contributing to the financial burden in these families.
Main Methods:
- A cross-sectional survey study was conducted comparing children with persistent OSA to a healthy control group.
- The Family Impact Questionnaire and the modified Comprehensive Score for Financial Toxicity (COST) were administered to families.
- Participants were recruited from an upper airway center at a tertiary pediatric hospital.
Main Results:
- Families of children with persistent OSA exhibited significantly lower COST scores, indicating greater financial toxicity (21.9 vs. 30.2, P = .003).
- Study families reported a higher financial impact on the Family Impact Questionnaire compared to controls (8.4 vs. 3.6, P = .002).
- Concerns about missed work and school days associated with treatment were frequently reported (30.7%).
Conclusions:
- Families of children with persistent OSA experience a substantial financial burden and increased financial toxicity.
- Missed work and school days related to appointments and treatment are significant contributors to the financial strain.
- Addressing the financial impact is crucial for improving the overall well-being of families affected by pediatric OSA.
Objective:
We previously found that financial concerns negatively affect the quality of life of families of children with persistent obstructive sleep apnea (OSA) after tonsillectomy. The goal is to quantify the financial impact on families of children with persistent OSA and assess contributing factors.
Study Design:
Cross-sectional survey study with comparison group.
Setting:
Upper airway center at a tertiary pediatric hospital.
Methods:
Participants included consecutive children with persistent OSA from September to October 2017. Healthy children seen in a general otolaryngology clinic served as controls. Families of both groups completed the Family Impact Questionnaire and the modified Comprehensive Score for Financial Toxicity (COST).
Results:
Families of the 50 patients (25 study and 25 control) completed the surveys: the mean age was 6.4 years (95% CI, 5.0-7.8), and 19 (38%) were female. There were no differences in age, sex, race, or insurance status between groups (P > .05). The mean apnea-hypopnea index for the study group was 7.9 events/h (range, 5.5-10.3), and 40% (10/25) had Down syndrome. Positive airway pressure and/or oxygen were used by 72% (18/25). The Comprehensive Score for Financial Toxicity for study patients (21.9; 95% CI, 14.8-26.0) was significantly lower than for controls (30.2; 95% CI, 26.6-30.8; P = .003), reflecting elevated financial toxicity. Study families reported greater financial impact on the Family Impact Questionnaire (8.4; 95% CI, 6.1-10.7) versus controls (3.6; 95% CI, 1.8-5.4; P = .002); concerns regarding missed days of work and school were common (30.7%).
Conclusion:
Families of children with persistent OSA reported a high financial burden related to their children's disease and were more likely to report financial toxicity than families of controls. Concern regarding missed work and school associated with appointments and treatment was a significant factor.
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