Qualitative interviews of 35 patients with OSA revealed that delays in diagnosis and treatment initiation were driven by symptom misattribution, minimization, denial, and lack of perceived threat.
Patients with OSA experience significant delays in diagnosis and treatment initiation due to symptom misattribution, denial, and minimization, highlighting the need for improved public awareness and psychological support.
Abstract Introduction Delays in seeking help and initiating treatment for obstructive sleep apnea (OSA) remain major barriers to timely diagnosis and improved outcomes for patients. This qualitative study examined patient experiences prior to OSA diagnosis with a focus on identifying factors that delayed diagnosis and treatment initiation as well as motivators that ultimately encourage patients to seek diagnosis. Methods In the parent study, thirty-five semi-structured telephone interviews with broad and open-ended questions were conducted to improve understanding of sex differences in OSA symptom presentation prior to diagnosis. For the current study, we examined those same patients’ experiences of the diagnostic process and their acceptance of treatment. The data were analyzed by two independent reviewers using a thematic approach and pattern coding. Any disagreements were resolved through consensus with the principal investigator. Results Participants (N=35; mean age=54± 14 years; 54.3% male, 45.7% female; 71.4% White, 28.6% African American) described two overarching themes: Delay in Diagnosis and Delay in Treatment Initiation, each containing several subthemes. In describing the Delay in Diagnosis which has four subthemes, participants routinely; 1) misattributed their symptoms to stress, chronic health conditions, or lifestyle factors. 2) Many also described minimizing their symptoms, often prioritizing work or family responsibilities over seeking care. 3) Denial was also common; several participants reported that they “knew something was wrong” yet were not willing to accept it. 4) Motivators that eventually pushed them to seek care included frightening episodes of gasping or choking, concerns expressed by partners or family members who witnessed breathing pauses, and, for some, stigma related to loud snoring. The Delay in Treatment Initiation was characterized by two subthemes in which participants were aware of their OSA diagnosis for years but did not initiate treatment since they were in 1) denial in accepting the diagnosis. 2) Some described postponing treatment because they did not see it as an immediate threat, seeking care only after their condition worsened. Conclusion Patients experience delays in acknowledging their symptoms, seeking care, and starting treatment. Improving public awareness, case-finding, and addressing patients’ psychological barriers and providing follow-up support to initiate treatment, may improve OSA outcomes by providing earlier treatment. Support (if any)
Asadollah et al. (2026) studied Obstructive Sleep Apnea (OSA) (n=35). Qualitative interviews of 35 patients with OSA revealed that delays in diagnosis and treatment initiation were driven by symptom misattribution, minimization, denial, and lack of perceived threat.