Patient-reported preferences for sleep apnoea treatments in an Australian community sample

Patient preferences for obstructive sleep apnoea (OSA) treatments contribute to long-term use. We aimed to assess patient preferences for OSA treatment options in an Australian community sample.

An online survey was administered to a community sample of people with self-reported diagnoses of OSA within Australia. Questionnaires addressed preferences for various treatment modalities, rating (visual analogue scales 0-100) the degree of acceptability of continuous positive airway pressure (CPAP), mandibular advancement splint (MAS), upper airway surgery, and pharmacological interventions in the form of oral medication or a nasal spray. Follow-up questions assessed the impact of side effects on acceptability scores for pharmacotherapies.

In 948 participants reporting a diagnosis of OSA, medications (in oral form or nasal spray) were rated as the most acceptable treatment option (Median [Q1-Q3], 86 [66-100]), significantly higher than CPAP (73 [50-91]), MAS (50 [27-75]) and upper airway surgery (50 [15-70]) (all p<.001). Around 58.2% and 72% of respondents rated medication as more acceptable than CPAP and MAS, respectively. Acceptability of CPAP was lower in females, non-obese patients and those with comorbid insomnia and OSA. Side effect profiles have substantial impacts on acceptability ratings, with headaches, nausea and gastrointestinal symptoms having the most detrimental impact on acceptability ratings, whereas nocturnal sleepiness was considered acceptable.

Our findings provide clear evidence for patient preference and acceptability of medication or nasal spray alternative therapies for OSA among patients in Australia. Side effect profiles have a large effect on tolerability ratings.