Illness perceptions of obstructive sleep apnea (OSA) and intention of performing clinical diagnostic examination for OSA in Chinese older adults

Abstract Background Obstructive sleep apnea (OSA) is highly prevalent, under-detected, but preventable among older adults. The Common Sense Model of Illness postulates that illness representations are associated with coping and behavioural outcomes. This study investigated the associations between i...

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Main Authors: Yanqiu Yu, Joyce Hoi-Yuk Ng, Mason M. C. Lau, Joseph T. F. Lau
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23278-y
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author Yanqiu Yu
Joyce Hoi-Yuk Ng
Mason M. C. Lau
Joseph T. F. Lau
author_facet Yanqiu Yu
Joyce Hoi-Yuk Ng
Mason M. C. Lau
Joseph T. F. Lau
author_sort Yanqiu Yu
collection DOAJ
description Abstract Background Obstructive sleep apnea (OSA) is highly prevalent, under-detected, but preventable among older adults. The Common Sense Model of Illness postulates that illness representations are associated with coping and behavioural outcomes. This study investigated the associations between illness representations of OSA and behavioral intention of clinical diagnostic examination for OSA (BICDE-OSA) under two conditional/unconditional situations, stratified by high-risk versus low-risk OSA. Methods A random population-based telephone survey interviewed 945 Chinese people aged ≥ 50 years without OSA diagnosis in the Hong Kong general population from February to November 2021. Results The prevalence of unconditional BICDE-OSA based on the participants’ current sleep situation was only 5.3%; that of conditional BICDE-OSA based on the hypothetical situation of having OSA was 54.3%. Significantly higher prevalence of conditional BICDE-OSA was found in the high-risk than the low-risk of OSA groups (64.4% versus 52.9%; p < 0.05); no significant between-group difference in unconditional BICDE-OSA was found. Illness representations of timeline chronic, timeline cyclical, consequences, and emotional representation were significantly associated with both conditional/unconditional BICDE-OSA (adjusted for background factors); illness coherence was significantly associated with conditional BICDE-OSA but not with unconditional BICDE-OSA. Conclusions High proportions of older people did not indicate conditional/unconditional BICDE-OSA, possibly resulting in low detection and treatment rates. As OSA was prevalent in the study population and the unconditional group showed a much higher prevalence of BICDE-OSA than the conditional group, the prevalence of BICID-OSA might increase if the high-risk people are made aware of their risk. Interventions modifying illness representations may be considered.
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spelling doaj-art-e8f0e767282d43bc86fe7b9ce83b74a42025-08-20T04:01:42ZengBMCBMC Public Health1471-24582025-07-0125111010.1186/s12889-025-23278-yIllness perceptions of obstructive sleep apnea (OSA) and intention of performing clinical diagnostic examination for OSA in Chinese older adultsYanqiu Yu0Joyce Hoi-Yuk Ng1Mason M. C. Lau2Joseph T. F. Lau3Department of Preventive Medicine and Health Education, School of Public Health, Fudan UniversityJockey Club School of Public Health and Primary Care, The Chinese University of Hong KongJockey Club School of Public Health and Primary Care, The Chinese University of Hong KongPublic Mental Health Center, School of Mental Health, Wenzhou Medical UniversityAbstract Background Obstructive sleep apnea (OSA) is highly prevalent, under-detected, but preventable among older adults. The Common Sense Model of Illness postulates that illness representations are associated with coping and behavioural outcomes. This study investigated the associations between illness representations of OSA and behavioral intention of clinical diagnostic examination for OSA (BICDE-OSA) under two conditional/unconditional situations, stratified by high-risk versus low-risk OSA. Methods A random population-based telephone survey interviewed 945 Chinese people aged ≥ 50 years without OSA diagnosis in the Hong Kong general population from February to November 2021. Results The prevalence of unconditional BICDE-OSA based on the participants’ current sleep situation was only 5.3%; that of conditional BICDE-OSA based on the hypothetical situation of having OSA was 54.3%. Significantly higher prevalence of conditional BICDE-OSA was found in the high-risk than the low-risk of OSA groups (64.4% versus 52.9%; p < 0.05); no significant between-group difference in unconditional BICDE-OSA was found. Illness representations of timeline chronic, timeline cyclical, consequences, and emotional representation were significantly associated with both conditional/unconditional BICDE-OSA (adjusted for background factors); illness coherence was significantly associated with conditional BICDE-OSA but not with unconditional BICDE-OSA. Conclusions High proportions of older people did not indicate conditional/unconditional BICDE-OSA, possibly resulting in low detection and treatment rates. As OSA was prevalent in the study population and the unconditional group showed a much higher prevalence of BICDE-OSA than the conditional group, the prevalence of BICID-OSA might increase if the high-risk people are made aware of their risk. Interventions modifying illness representations may be considered.https://doi.org/10.1186/s12889-025-23278-yObstructive sleep apneaIllness perceptionIllness representationOlder peopleCommon sense modelChinese
spellingShingle Yanqiu Yu
Joyce Hoi-Yuk Ng
Mason M. C. Lau
Joseph T. F. Lau
Illness perceptions of obstructive sleep apnea (OSA) and intention of performing clinical diagnostic examination for OSA in Chinese older adults
BMC Public Health
Obstructive sleep apnea
Illness perception
Illness representation
Older people
Common sense model
Chinese
title Illness perceptions of obstructive sleep apnea (OSA) and intention of performing clinical diagnostic examination for OSA in Chinese older adults
title_full Illness perceptions of obstructive sleep apnea (OSA) and intention of performing clinical diagnostic examination for OSA in Chinese older adults
title_fullStr Illness perceptions of obstructive sleep apnea (OSA) and intention of performing clinical diagnostic examination for OSA in Chinese older adults
title_full_unstemmed Illness perceptions of obstructive sleep apnea (OSA) and intention of performing clinical diagnostic examination for OSA in Chinese older adults
title_short Illness perceptions of obstructive sleep apnea (OSA) and intention of performing clinical diagnostic examination for OSA in Chinese older adults
title_sort illness perceptions of obstructive sleep apnea osa and intention of performing clinical diagnostic examination for osa in chinese older adults
topic Obstructive sleep apnea
Illness perception
Illness representation
Older people
Common sense model
Chinese
url https://doi.org/10.1186/s12889-025-23278-y
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