Knowledge, Attitudes, and Practices Toward Obstructive Sleep Apnea in China: A Structural Equation Modeling Study

Self-management is essential for the management of obstructive sleep apnea (OSA); however, the general public's understanding of OSA in China remains unclear. This study aimed to investigate the knowledge, attitudes, and practices (KAP) concerning OSA among Chinese adults. This information is essential for informing population-level prevention strategies and strengthening public health responses to OSA.

This cross-sectional study was conducted between October 2022 and October 2023 among Chinese adults. Based on a knowledge-attitude-practice conceptual framework, we hypothesized that knowledge would directly influence attitudes, attitudes would directly influence practices, and knowledge would exert both direct and indirect effects on practices.

A total of 1,145 questionnaires were collected, and 850 valid responses were analyzed (valid response rate: 74.76%). The mean scores for knowledge, attitudes, and practices were 20.84 (0-42), 37.96 (9-45), and 38.03 (10-50), respectively. Knowledge was positively associated with attitude (r = 0.502, P < 0.001) and practice (r = 0.434, P < 0.001), while attitude showed a strong correlation with practice (r = 0.722, P < 0.001). Structural equation modeling showed that education positively affected knowledge (β = 0.166, P = 0.005). Knowledge directly influenced attitude (β = 0.502, P < 0.001) and practice (β = 0.096, P < 0.001), and indirectly affected practice through attitude (β = 0.338, P = 0.012). Attitude had a strong direct effect on practice (β = 0.674, P < 0.001).

Chinese adults demonstrated a limited understanding of OSA; however, they generally exhibited positive attitudes and moderate engagement in related practices. This study emphasized the need to strengthen public knowledge about OSA, which may support improvements in attitudes and practices. The observed pathways among knowledge, attitudes, and practices suggest that increasing public awareness could play an important role in shaping health-related behaviors.