Sawunyavisuth Bundit, Heingraj Sasawan, Amornpan Suwakitti, Jongudomkarn Darunee, Sawanyawisuth Kittisak
Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand.
Department of Business Administration, College of Business and Entrepreneurship, Winston-Salem State University, Winston-Salem, NC, USA.
Sci Rep. 2025 Jul 1;15(1):21074. doi: 10.1038/s41598-025-07923-5.
Obstructive sleep apnea (OSA) is very prevalent in older adults and causes several cardiovascular diseases as well as neurological conditions such as cognitive impairment. These consequences of OSA can be prevented by treatment with a continuous positive airway pressure machine (CPAP). Even though CPAP is effective, not all older adults with OSA purchased it for personal use. This study aimed to evaluate why older adults with OSA denied purchasing CPAP by using a qualitative study. This was a qualitative study among older adults diagnosed with OSA, participated in the CPAP titration trial for at least three nights, and denied purchasing the CPAP. An in-depth interview was performed in eligible patients until data saturation to find factors or themes whether older adults did not purchase CPAP. There were 15 older adults with OSA who did not purchase CPAP and participated in the study. The average (SD) age of all patients was 67.73 (5.84) years with a proportion of male patients of 46.67% (7 patients). There were three themes on why the older adults with OSA did not purchase CPAP including financial constraints, lack of family financial support, and OSA perspectives. Older adults with OSA who did not purchase CPAP did not want to treat OSA, though they already had several consequences of OSA. They believed that they had OSA for a long time and wanted to live with OSA resulting in denying CPAP therapy. Conservative treatment with other options was justified for them. Additionally, they were not afraid of death and expected to die peacefully. Older adults who did not purchase CPAP for their personal use may be mainly due to unaffordability to CPAP by any reason. Universal health insurance coverage for older adults with OSA may enhance CPAP acceptability.
阻塞性睡眠呼吸暂停（OSA）在老年人中非常普遍，会引发多种心血管疾病以及认知障碍等神经疾病。OSA的这些后果可以通过使用持续气道正压通气机（CPAP）进行治疗来预防。尽管CPAP有效，但并非所有患有OSA的老年人都购买它以供个人使用。本研究旨在通过定性研究评估患有OSA的老年人拒绝购买CPAP的原因。这是一项针对被诊断患有OSA、参加了至少三晚CPAP滴定试验且拒绝购买CPAP的老年人的定性研究。对符合条件的患者进行深入访谈，直至数据饱和，以找出老年人不购买CPAP的因素或主题。有15名患有OSA且未购买CPAP并参与研究的老年人。所有患者的平均（标准差）年龄为67.73（5.84）岁，男性患者比例为46.67%（7名患者）。关于患有OSA的老年人不购买CPAP的原因有三个主题，包括经济限制、缺乏家庭经济支持以及对OSA的看法。未购买CPAP的患有OSA的老年人虽然已经出现了OSA的多种后果，但他们不想治疗OSA。他们认为自己患OSA的时间很长，想与OSA共存，从而拒绝CPAP治疗。对他们来说，采用其他选择的保守治疗是合理的。此外，他们不害怕死亡，期望平静地死去。未购买CPAP供个人使用的老年人可能主要是由于任何原因无力承担CPAP费用。为患有OSA的老年人提供全民健康保险覆盖可能会提高CPAP的可接受性。
