Factors influencing patient delay in individuals with obstructive sleep apnoea: a study based on an integrated model

Figures & data

Figure 1. Hypothesised integrative model of patient delay among individuals with obstructive sleep apnoea. HEM: the health ecological model; TPB: the theory of planned behaviour.

Table 1. Sociodemographic information and disease characteristics s of the subjects (n = 309).

Variables	Options	N	Percentage
Gender	Male	262	84.8
	Female	47	15.2
Age (years)	<40	94	30.4
	40∼	175	56.7
	60∼	40	12.9
Marital status	Never married	30	9.7
	Married/cohabitated	253	81.9
	Divorced/widowed	26	8.4
Employment status	In-service	184	59.5
	Retired	45	14.6
	Unemployed	80	25.9
Education background	Primary school	65	21.0
	Middle school	89	28.8
	High school	103	33.3
	≥Graduate	52	16.8
Per capita monthly family income (RMB)	<1500	46	14.9
	1500∼	111	35.9
	3000∼	93	30.1
	4500∼	59	19.1
Place of residence	Rural area	143	46.3
	City or town	166	53.7
Smoking behaviour	No smoking	130	42.1
	Occasional smoking	84	27.2
	Regular smoking	95	30.7
Alcohol drinking behaviour	No alcohol drinking	140	45.3
	Occasional drinking	85	27.5
	Regular drinking	84	27.2
Impact of COVID-19	No impact	232	75.1
	having impact	77	24.9
Regular physical examination status	Yes	169	54.7
	No	140	45.3
Comorbid chronic diseases	One or more	205	66.3
	No	104	33.7
AHI	Mild	37	12.0
	Moderate	70	22.7
	Severe	202	65.4
LSaO2	Mild	81	26.2
	Moderate	75	24.3
	Severe	153	49.5
Years of snoring	<3	64	20.7
	3∼	53	17.2
	6∼	47	15.2
	10∼	145	46.9
BMI	Underweight	1	0.3
	Normal weight	25	7.8
	Overweight	129	41.7
	Obese	155	50.2

AHI: apnoea-hypopnea index; LSaO₂: lowest arterial oxygen saturation; BMI: body mass index

Table 2. Symptom type of the participants (n = 309).

Symptoms	N	Pct of responses	Pet of cases
Soring	227	33.58	73.46
Waking up, suffocation during sleep	216	31.95	69.90
Dizziness, headache, dry mouth	53	7.84	17.15
Daytime sleepiness, fatigue	70	10.36	22.65
Cardiovascular disease, cerebrovascular disease, diabetes, hypertension, etc.	84	12.43	27.18
Other clinical symptoms or diseases^a	26	3.84	8.50
Total	676	100.00	218.77

The pct of responses in the table was calculated as the ratio of the occurrence of a certain symptom to the total number of occurrences of all symptoms; the pct of cases was calculated as the ratio of patients with this symptom to the total subjects; ^aother clinical symptoms or diseases included cough, reflux disease, nightmares, etc.

Table 3. Descriptive statistics of patient delay (n = 309).

	Maximum value	Minimum value	Median	IQR
Total	456.0	0.5	22.0	37.0
Delay group	456.0	3.0	24.0	37.5
Non-delay group	2.0	0.5	2.0	0.5

The time unit is the month.

Table 4. Descriptive statistics of provider delay (n = 309).

	<1	1∼	3∼	6∼	9∼	12∼
N	98	119	24	22	14	32
Percentage	31.7	38.5	7.8	7.1	4.5	10.4

The time unit is the month.

Table 5. The univariate analysis of factors affecting the patient delay.

	N (%) or median (IQR)
Variables	Short-delay (n = 135)	Long-delay (n = 149)	χ^2/Z value	p
Upstream factors
Marital status			1.736	0.420
Never married	15 (11.1)	11 (7.4)
Married/Cohabitated	111 (82.2)	124 (83.2)
Divorced/Widowed	9 (6.7)	14 (9.4)
Employment status			5.122	0.077
In-service	89 (65.9)	79 (53.0)
Retired	15 (11.1)	26 (17.4)
Unemployed	31 (23.0)	44 (29.5)
Education background			31.777	0.000
Primary school	15 (11.1)	46 (30.9)
Middle school	33 (24.2)	51 (34.2)
High school	54 (40.0)	41 (27.5)
≥Graduate	33 (24.4)	11 (7.4)
Per capita monthly family income (RMB)			33.214	0.000
<1500	8 (5.9)	34 (22.8)
1500∼	39 (28.9)	65 (43.6)
3000∼	53 (39.3)	34 (22.8)
4500∼	35 (25.9)	16 (10.7)
Place of residence			28.181	0.000
Rural area	40 (29.6)	91 (61.1)
City or town	95 (70.4)	58 (38.9)
Impact of COVID-19			3.980	0.046
No impact	95 (70.4)	120 (80.5)
Having impact	40 (29.6)	29 (19.5)
Objective support	8.0 (5.0)	6.0 (4.0)	−3.915	0.000
Subjective support	18.0 (4.0)	16.0 (5.0)	−3.465	0.001
Utilization of support	7.0 (3.0)	6.0 (3.0)	−1.706	0.088
Midstream factors
Smoking behaviour			4.542	0.103
No smoking	56 (41.5)	62 (41.6)
Occasional smoking	43 (31.9)	33 (22.1)
Regular smoking	36 (26.7)	54 (36.2)
Alcohol drinking behaviour			6.435	0.040
No drinking	63 (46.7)	64 (43.0)
Occasional drinking	43 (31.9)	34 (22.8)
Regular drinking	29 (21.5)	51 (34.2)
Regular physical examination			7.915	0.005
Yes	85 (63.0)	69 (46.3)
No	50 (37.0)	80 (53.7)
Self-efficacy	7.5 (1.7)	6.5 (2.0)	−6.430	0.000
Self-recognition	9.0 (2.0)	9.0 (8.0)	−3.668	0.000
Emotional experience	18.0 (8.0)	17.0 (6.5)	−1.275	0.202
Help-seeking intention	9.0 (2.0)	9.0 (2.0)	−1.863	0.062
Downstream factors
Gender			0.113	0.736
Male	115 (85.2)	129 (86.6)
Female	20 (14.8)	20 (13.4)
Age (years)			15.152	0.001
<40	53 (39.3)	33 (22.1)
40∼	73 (54.1)	88 (59.1)
60∼	9 (6.7)	28 (18.8)
Comorbid chronic diseases			13.746	0.000
One or more	30 (22.2)	64 (43.0)
No	105 (77.8)	85 (57.0)
AHI			0.409	0.815
Mild	17 (12.6)	18 (12.1)
Moderate	32 (23.7)	31 (20.8)
Severe	86 (63.7)	100 (67.1)
LSaO2			1.134	0.567
Mild	32 (23.7)	40 (26.8)
Moderate	37 (27.4)	33 (22.1)
Severe	66 (48.9)	76 (51.0)
Years of snoring			35.143	0.000
<3	43 (31.9)	15 (10.1)
3∼	29 (21.5)	15 (10.1)
6∼	17 (12.6)	26 (17.4)
10∼	46 (34.1)	93 (62.4)
BMI			3.177	0.204
Underweight	1 (0.7)	0 (0.0)
Normal	9 (6.7)	9 (9.0)
Overweight	65 (48.1)	58 (38.9)
Obese	60 (44.4)	82 (55.0)

AHI: apnoea-hypopnea index; LSaO₂: lowest arterial oxygen saturation; BMI: body mass index

Bold values correspond to statistically significant correlations (p < 0.05).

Table 6. Logistic regression analysis of factors associated with patient delay.

Variable	Comparison group	Reference group	β	S.E.	Waldχ^2	p	OR	95%CI
Age (year)	40∼	<40	−0.221	0.408	0.294	0.587	0.802	0.360 − 1.783
	60∼		0.623	0.660	0.893	0.345	1.865	0.512 − 6.794
Education background	Middle school	Primary school	−0.043	0.468	0.009	0.926	0.958	0.383 − 2.396
	High school		−0.002	0.511	0.000	0.996	0.998	0.366 − 2.718
	≥Graduate		0.035	0.746	0.002	0.962	1.036	0.240 − 4.467
Income (RMB)	1500∼	<1500	−0.861	0.535	2.586	0.108	0.423	0.148 − 1.207
	3000∼		−1.758	0.611	8.272	0.004	0.172	0.052 − 0.571
	4500∼		−1.464	0.721	4.118	0.042	0.231	0.056 − 0.951
Place of residence	City or town	Rural area	−0.725	0.342	4.511	0.034	0.484	0.248 − 0.946
Drinking behaviour	Occasional	No drinking	−0.358	0.380	0.887	0.346	0.699	0.332 − 1.472
	Regular drinking		0.034	0.388	0.008	0.931	1.034	0.484 − 2.212
Impact of COVID-19	Having impact	No impact	0.091	0.391	0.054	0.816	1.095	0.509 − 2.358
Chronic diseases	One or more	No	−0.081	0.368	0.049	0.825	0.922	0.448 − 1.898
Physical examination	No	Yes	−0.134	0.338	0.158	0.691	0.874	0.451 − 1.696
Years of snoring	3∼	<3	0.356	0.532	0.448	0.503	1.428	0.503 − 4.049
	6∼		1.217	0.538	5.108	0.024	3.377	1.175 − 9.702
	10∼		1.270	0.496	6.540	0.011	3.559	1.345 − 9.418
Self-recognition			−0.232	0.104	4.974	0.026	0.793	0.647 − 0.972
Objective support			−0.192	0.056	11.726	0.001	0.825	0.739 − 0.921
Subjective support			0.009	0.046	0.035	0.851	1.009	0.922 − 1.103
Self-efficacy			−0.394	0.128	9.464	0.002	0.674	0.525 − 0.867
Constant			6.853	1.558	19.339	0.000

β: standardized Beta coefficient; S.E: standard error; OR: odds ratio; CI: confidence interval

Bold values correspond to statistically significant correlations (p < 0.05).

Data availability statement

The data that support the findings of this study are available from the corresponding author CL, upon reasonable request.