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Patient Preferences for Obstructive Sleep Apnea Treatment Attributes: A Discrete Choice Experiment Among CPAP Users
Takahiro Tokunaga1, Ryo Sato1, Yasuhiro Manabe1
1Otorhinolaryngology, Shinseikai Toyama Hospital, Toyama, Japan.
Sleep
|May 18, 2026
Summary
Japanese patients with obstructive sleep apnea (OSA) prioritize sleep quality improvement with CPAP therapy. Poor adherence may increase the value of frequent clinic visits for essential support.
Area of Science:
- Sleep Medicine
- Health Economics
- Patient Preferences
Background:
- Obstructive sleep apnea (OSA) affects millions globally, necessitating effective Continuous Positive Airway Pressure (CPAP) therapy.
- Understanding patient preferences is crucial for optimizing adherence and treatment outcomes in OSA management.
- Japanese healthcare context may influence patient priorities regarding CPAP therapy attributes.
Purpose of the Study:
- Quantify treatment attribute preferences among Japanese patients with CPAP-treated OSA.
- Estimate willingness-to-pay (WTP) for different CPAP therapy attributes.
- Examine how CPAP adherence status influences these preferences and WTP.
Main Methods:
- Discrete choice experiment conducted with 161 CPAP-treated OSA patients in Japan.
- Evaluated preferences for sleep quality, usage frequency, side effects, clinic visits, and cost.
- Analyzed preferences using conditional logit models and estimated WTP via Delta-method; adherence heterogeneity assessed via stratified models.
Main Results:
- Sleep quality improvement was the most valued attribute (42.4% relative importance; WTP ¥5298/month).
- Patients showed negative preferences for reduced clinic visits and non-significant negative preference for side effect burden.
- Significant preference differences observed between adherence groups, though WTP comparisons were not statistically significant.
Conclusions:
- Japanese OSA patients prioritize treatment efficacy but value frequent healthcare contact, especially those with poor CPAP adherence.
- Clinic visits may be perceived as essential support for adherence among certain patient groups.
- Findings suggest the need for adherence-stratified care and shared decision-making informed by patient preferences.
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