Obstructive sleep apnoea (OSA) in regional and remote Indigenous Australians

Background: Despite Aboriginal and Torres Strait Islander people having increased risk factors for OSA (diabetes, obesity) and high levels of comorbid associated conditions (chronic non-communicable diseases), there are currently no published data relating to the nature of sleep related breathing disorders affecting Indigenous adults. Aims/Objectives: The aim of this study was to compare the use of sleep diagnostic tests, the risks, and cofactors, and outcomes of the care of Indigenous and non-indigenous Australian adults in regional and remote Australia in whom sleep related breathing disorders have been diagnosed. Methods: A retrospective cohort study of 200 sequential subjects: 100 Aboriginal and/or Torres Strait Islander people and 100 non-Indigenous Australians in northern Queensland and Central Australia. Results: Results showed overall Indigenous Australians were 1.8 times more likely to have a positive diagnostic sleep study performed compared with non-indigenous patients, 1.6 times less likely in central Australia and 3.4 times more likely in far north Queensland. All regional and remote residents accessed diagnostic sleep studies at a rate less than Australia overall (31/100,000/y compared with 575/100,000/y). Discussion: Appropriate and more accessible diagnostic and treatment sleep services are required in regional and remote Australia. Further research is required to validate appropriate screening tools and pathways of care especially for Aboriginal and Torres Strait Islander peoples

Diagnosis and management of obstructive sleep apnoea in Indigenous people in Central and Northern Australia

Background / Aims: There is currently no literature regarding diagnosis and management of sleep-related breathing disorders, such as obstructive sleep apnoea (OSA), in Australian Aboriginal and Torres Strait Islander peoples. Anecdotal experience suggests sleep-related breathing disorders are under diagnosed and variably managed in Central and Northern Australia. This study aimed to investigate the nature, risk factors and outcomes of people with sleep-related breathing disorders, and to compare and contrast severity, risk factors and management in Indigenous and non-Indigenous Australian patients.\ud \ud Methods: A retrospective cohort study of 200 patients. Subjects were 50 consecutive Aboriginal and Torres Strait Islander patients and 50 consecutive non-Indigenous patients who attended a Northern Queensland and Central Australian sleep clinic and were diagnosed with a sleep disorder. Retrospective data collected from patients’ medical records included demographics, co-morbidities, BMI, fatigue score, referral source, diagnosis and severity, and management details for 12 months following diagnosis.\ud \ud Results: Aboriginal Australians in Central Australia were 2.3 times less likely to have a sleep disorder diagnosed compared with non-Indigenous Australians and Indigenous patients in Northern Australia were 2.9 times less likely to have a sleep disorder diagnosed compared with non-Indigenous patients. Indigenous patients were also twice as likely not to attend follow-up appointments in the 12 months following their diagnostic study (38%, 95% CI 27-49 compared with 19%, 11-30, p= 0.014).\ud \ud Conclusion: sleep-related breathing disorders are a significant issue for regional and remote Aboriginal and Torres Strait Islander patients. Potential barriers and enablers to care in this setting will be discussed