Public engagement with consumer sleep technology for obstructive sleep apnea screening: implications for equity, access, and practice

Study Objectives: To characterize public practices and perspectives on the use of consumer sleep technology (CST) and evaluate perspectives on using CST as a screening tool for obstructive sleep apnea. Methods: We designed a survey instrument incorporating content from validated instruments (STOP-Bang and the Epworth Sleepiness Scale) and hypothesis-generated questions. Survey development involved multidisciplinary collaboration among 3 board-certified sleep medicine experts, researchers, and consumers. The survey was disseminated across a national sample of adults living in the United States via an online platform. Results: Among 897 respondents, the mean (standard deviation) age was 47.5 (16.9) years; 73.1% were female, 81.8% were White, and 505 respondents (56.3%) reported having tracked sleep using CST. Factors associated with decreased odds of CST use included household income <$30,000 (odds ratio [OR] 0.47,95% confidence interval [CI] 0.28-0.79; P = .004), Medicaid insurance (OR 0.43,95% CI 0.26-0.69; P = .001), Medicare insurance (OR 0.59, 95% CI 0.41-0.84; P = .004), and lack of a primary care physician (OR 0.55, 95% CI 0.33-0.91; P = .021). Most respondents (91.1%) agreed or strongly agreed that screening for obstructive sleep apnea would be a useful feature of CST, but respondents reporting an education of high school diploma or less (OR 0.48, 95% CI 0.29-0.79; P = .004) were less likely to agree with this statement. Conclusions: Attitudes toward and use of CST differed based on demographic and socioeconomic factors. Further study is needed to understand and address barriers to CST adoption and to characterize implications for equitable access to care for sleep disorders.