Clinician attitudes and knowledge of pediatric sleep-disordered breathing

Objectives: : The goals of this study are to assess primary care provider (PCP) knowledge of and attitudes toward pediatric obstructive sleep apnea (OSA), and to identify variations in practice patterns. Design: : A cross-sectional survey including the Obstructive Sleep Apnea Knowledge and Attitudes in Children (OSAKA-KIDS) questionnaire was administered to PCPs from August to December 2021. Univariable analyses and multivariable linear regressions were performed to analyze associations between demographics and knowledge, attitudes, and screening frequency. Results: : There were 82 PCPs who completed the survey (age 43.4 ±9.6 years, 69.6% female, 90.2% non-Hispanic White). Specialties included Pediatrics (65.9%) and Family Medicine (32.9%). Respondents answered a mean 84.9 ±10.7% questions correctly on the knowledge portion. Years in practice, provider training background, and academic affiliation were not associated with knowledge scores. Less than half (45.1%) of respondents screened for OSA ‘most of the time’ (32.9%) or ‘always’ (12.2%). Higher screening frequency was associated with clinics with higher Medicaid beneficiaries (P=0.002) and a lower proportion of Black patients (P=0.033). Providers who felt more confident in managing OSA were more likely to screen ‘most of the time’ (B=0.532, 95%CI [0.120 – 0.926], P=0.012), or ‘always’ (B=0.708, 95%CI [0.129 – 1.29], P=0.017). Conclusion: : These results suggest guideline-recommended screening for OSA is low among PCPs despite high knowledge scores. Higher confidence in OSA management was associated with higher screening rates for obstructive sleep-disordered breathing. Further studies on interventions aimed to increase screening and confidence may improve equitable care.