Facilitating factors and barriers in the screening and diagnosis process of obstructive sleep apnea in taxi drivers

AIM: To evaluate the prevalence of morning and day sleepiness and obstructive sleep apnea syndrome (OSAS) among taxi drivers of the Athens airport and to examine the factors that may influence a taxi driver's decision to participate in screening. METHODS: Demographic, sleep and work-related data were obtained for 840 professional drivers through a self-administered questionnaire based on Berlin scale variables; individuals identified at high OSAS risk were thereafter identified and offered cost-free nocturnal pulse-oximeter and sleep study. A qualitative study was subsequently conducted among those who declined participation aiming to identify facilitating factors and barriers to attend screening and diagnosis. RESULTS: One out of 4 participants was identified as high-risk, a similar to 80% provided further contact details, whereas similar to 75% of those contacted declined further participation; 17 out of the 22 who attended the diagnosis process suffered OSA. Drivers who declined participation were more likely to smoke, snore loudly and work on night-shifts. Non-participants did not perceive personal health as a priority, acknowledged the need for preventive healthcare but valued its practical uptake as difficult. Exposure to high stress levels along with struggle to combat financial survival was highly prioritized as a barrier, whereas suggestions for facilitating factors to improve participation included on-site examination and monetary incentives. CONCLUSIONS: Drivers were found to be high-risk for OSA but a hard to reach professional group unaware about on the associated personal and societal risk encountered. Increase efforts to raise awareness and tailoring of the medical evaluation process to individual needs are of paramount importance.