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