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Lived experience of patients with sleep apnea: a systematic synthesis of qualitative evidence

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Abstract

Background

Sleep apnea (SA) is a prevalent chronic disease with significant morbidity that negatively impacts a patient’s perception of health and quality of life (QoL).

Objective

This review synthesized qualitative evidence on the experiences of patients living with SA to understand the disease’s impacts on QoL.

Methods

We performed a systematic review of qualitative studies and searched eight electronic databases from inception dates to 22 September 2020. We analyzed the data using Sandelowski’s proposed method of meta-synthesis, and applied Critical Appraisal Skills Program (CASP) and GRADE-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) criteria to appraise the studies’ qualities, and synthesized findings, respectively.

Results

Fourteen qualitative studies met the selection criteria. Four themes and 16 subthemes emerged: (1) sleep-related manifestations (n = 14) with four subthemes (sleep disruptors; sleepiness & napping; fatigue & low energy level; decreased cognition), (2) reduced psychological well-being and functioning (n = 14) with seven subthemes (anxiety & feeling vulnerable; hostility; sadness, sense of hopelessness & depression; embarrassment, shame & diminished self-concept; guilt & self-blame; maladaptive coping; self-stigma, (3) impaired physical and role functioning (n = 13) with three subthemes (reduced activities & routine disruption; reduced sexual activities & desire; reduced job performance & participation), (4) impaired social and relational functioning (n = 13) with two subthemes (strained interpersonal relationships; social isolation & loneliness).

Conclusions

SA patients experienced sleep-disrupting symptoms and daytime sleepiness/fatigue which adversely impacted physical, psycho-cognitive, and social aspects of their lives in complex interactive ways. This understanding can help facilitate patient-centric care and develop comprehensive patient-reported measures to effect good health outcomes.

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Data availability statement

Supporting data can be found in the electronic supplementary materials (ESM) available at https://doi.org/10.1007/s1136-022-03332-7.

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Acknowledgements

The team would like to acknowledge Ms. Annelissa Chin Mien Chew, a senior librarian from National University Singapore for her advice and guidance in coming up with the search strategy.

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No funding was required for this study.

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Authors and Affiliations

  1. Department of Medicine, JurongHealth Campus, National University Health System, Singapore, Singapore

    Ai-Ping Chua

  2. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Ai-Ping Chua, Zhi Yi Soh & Nan Luo

  3. Allied Health, JurongHealth Campus, National University Health System, Singapore, Singapore

    Shaffinaz Abd Rahman

  4. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Shefaly Shorey

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Contributions

All authors contributed to the study. A-PC & NL conceptualized the study. A-PC, SS & NL designed the study. All authors contributed to data collection and analysis at various stages of the investigation. The first draft of the manuscript was written by, and all tables and figures were prepared by A-PC. Reviewing and editing were performed by A-PC, SS and NL. ZYS proofread the final manuscript. The work was supervised by NL. All authors read and approved the final manuscript.

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Correspondence to Ai-Ping Chua.

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Chua, AP., Soh, Z.Y., Rahman, S.A. et al. Lived experience of patients with sleep apnea: a systematic synthesis of qualitative evidence. Qual Life Res 32, 1447–1467 (2023). https://doi.org/10.1007/s11136-022-03332-7

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