OSA in SMI qualitative study
Research type
Research Study
Full title
Exploration of barriers and facilitators to the detection and treatment of obstructive sleep apnoea in people with severe mental illness: a qualitative study
IRAS ID
297422
Contact name
Sophie M Faulkner
Contact email
Sponsor organisation
Greater Manchester Mental Health NHS Foundation Trust
Duration of Study in the UK
0 years, 9 months, days
Research summary
Summary of Research
In obstructive sleep apnoea (OSA) the airway collapses during sleep, causing repeated arousals to restore the airway. The person is usually unaware of these arousals and may not complain, although they may report subjectively poor sleep (1). When sustained and untreated this is linked to a number of adverse health and wellbeing outcomes, such as daytime sleepiness, impaired cognitive functioning, and reduced quality of life, and cardiometabolic illness (2). \nObstructive sleep apnoea is common in the general population (3), and even more common in people with schizophrenia (4–6) and with severe mental illness (SMI) (7–10). Yet rates of diagnosis appear to be low in this group (7,8), there are a number of possible reasons for this, including diagnostic overshadowing, or possible reluctance to be assessed, however neither rates of detection, nor barriers to detection, have been comprehensively studied.\nThis study will explore views of patients and staff regarding current practices in the detection, assessment of, and treatment of OSA. It will explore what people perceive to be the problems, and possible solutions to improve this. Views will be explored through individual qualitative interviews which will be transcribed and analysed. The aim is that this work will help inform possible changes in practice which could be tested in future.\n
Summary of Results
Non-sleep specialists often lacked awareness of obstructive sleep apnoea, which was a barrier to people being referred for assessment and treatment. There were also complicating factors preventing easy identification of possible sleep apnoea in people with mental health problems, as symptoms of sleep apnoea could be mistaken for symptoms of mental illnesses or side effects of medications.
Using sleep apnoea treatment (continuous positive airway pressure - CPAP) was not easy to get used to and could feel invasive, or be seen negatively, but for those who persevered it could be life-changing, and make managing one's mental health much easier. Some professionals didn't see sleep apnoea detection and treatment as a high priority, because the treatment can be unpalatable or because they thought treating sleep apnoea might not make a big difference. People who had seen the impact of successful treatment talked about how it is important to promote the importance of sleep apnoea detection and treatment.
Participants felt professionals who work with people with mental illnesses should be involved in helping to detect possible sleep apnoea, and sometimes in supporting people to use the treatment. Also participants felt sleep services should provide assessment and treatment in a way that makes sure it is accessible to people with mental health difficulties.REC name
South Central - Oxford B Research Ethics Committee
REC reference
21/SC/0184
Date of REC Opinion
2 Jun 2021
REC opinion
Favourable Opinion