0504 Unraveling the Relationships Between Chronic Illness, Healthcare Access, and Obstructive Sleep Apnea in Nigeria

Abstract

Abstract Introduction Diagnosing Obstructive Sleep Apnea (OSA) in the wider population in Sub-Saharan Africa is challenging, while co-morbidity with other chronic illnesses and Cardiovascular disease is still unestablished. For the few individuals with established sleep disorders and chronic illness, poor health-seeking behaviour has contributed to this gap. This population-based survey assessed associations between chronic illness, healthcare access and OSA in Nigeria Methods A cross-sectional study was conducted among 2388 respondents in North Central Nigeria using the STOP-BANG Questionnaire (ESQ) tool and Epworth Sleepiness Scale (ESS). A multistage sampling technique was used. Data collected was analyzed using SPSS IBM V.23. Descriptive and inferential statistics to test associations between categorical variables were analyzed. The level of statistical significance was set at p< 0.05 at 95% confidence level Ethical approval (ERC/MOH/2023/11/164) was obtained from the Ethical Review Committee of the Kwara State Ministry of Health. Results Of 2388 respondents, 683 (28.6%) were less than 50 years old, and 18.2% reported chronic illness, with hypertension being the most reported (59.1%). About 92% of those with chronic illness were on medications, and only 40.7% accessed hospital follow-up. About a third (33.3%) reported that the chronic illness affected their daily work and activities. Following medical measurement, 8.5% were underweight, 21.2% overweight, and 11.4% obese. About 16.6% had elevated diastolic blood pressure, while 21.9% had elevated systolic blood pressure. Of the respondents who reported sleep problems, SBQ classified 50% of them as having moderate to high risk of OSA (p< 0.001). There were significantly higher risks of sleepiness and OSA among the respondents who reported having chronic illness in both ESS (p=0001) and SBQ (p< 0.0001) scales. Similarly, high blood pressure and obesity were significantly associated with a high risk of sleepiness and OSA in SBQ (p=0.001) and ESS(p=0.004) scales respectively. The SBQ scale also revealed a significantly lower health facility utilization rate among respondents with a high risk of sleepiness (p< 0.001) Conclusion There is a higher risk of sleepiness and OSA among the Nigerian population with chronic illness, many of whom have low healthcare access. This poses the danger of undiagnosed and iceberg phenomena in diagnosing OSA in low-resource settings. Support (if any)