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dc.contributor.authorLi, Joule J
dc.contributor.authorAppleton, Sarah L
dc.contributor.authorWittert, Gary Allen
dc.contributor.authorVakulin, Andrew
dc.contributor.authorMcEvoy, Ronald Douglas
dc.contributor.authorAntic, Nicholas Alexander
dc.contributor.authorAdams, Robert J
dc.identifier.citationLi, J., Appleton, S., Wittert, G., Vakulin, A., McEvoy, R., Antic, N., et al. (2014). The Relationship between Functional Health Literacy and Obstructive Sleep Apnea and its Related Risk Factors and Comorbidities in a Population Cohort of Men. Sleep, 37(3) pp. 571-578.en
dc.descriptionAuthor manuscript version freely available online at PubMed Central <>en
dc.description.abstractSTUDY OBJECTIVES: To examine the relationship between functional health literacy (FHL) and obstructive sleep apnea (OSA), its diagnosis, related risk factors, and comorbidities. DESIGN: Population cohort study. SETTING: Adelaide, South Australia, 2011-12. PARTICIPANTS: 1,021 Men Androgen Inflammation Lifestyle Environment and Stress Study participants aged ≥ 40 years, of whom 627 were identified with OSA by self-report (n = 184 previously diagnosed) or with in-home polysomnography in 837 randomly selected participants without self-reported OSA (n = 443 previously undiagnosed). INTERVENTIONS: The Newest Vital Sign assessed FHL in 88% of participants. Full in-home unattended polysomnography (Embletta X100) was scored by 2007 AASM (alternative) criteria. MEASUREMENTS AND RESULTS: FHL was adequate in 75.3% (n = 122) of previously diagnosed and 68.3% (n = 261) of previously undiagnosed OSA. Not having a previous diagnosis was independently associated with inadequate FHL (odds ratio [OR]:2.84, 95% confidence interval [CI]:1.25-6.45) and workforce participation (OR = 2.04, 95% CI = 1.01-4.00), and inversely associated with previous snoring (OR = 0.48, 95% CI = 0.29-0.81), obesity (OR = 0.35, 95% CI = 0.15-0.81), and cardiovascular disease (OR = 0.45, 95% CI = 0.24-0.85). In polysomnography participants, inadequate FHL was independently associated with previously undiagnosed OSA (OR = 2.43, 95% CI = 1.40-4.20). In undiagnosed men, less than adequate FHL was independently associated with sedentary lifestyle (OR = 2.42, 95% CI = 1.36-4.29), and depression (OR = 2.50, 95% CI = 1.23-5.09) and inadequate FHL was associated with current smoking (OR = 2.87, 95% CI = 1.21-6.84). The depression association was attenuated after additional adjustment for comorbidities and general health (OR = 2.04, 95% CI = 0.93-4.49, P = 0.076). In previously diagnosed OSA, less than adequate FHL was independently associated with cardiovascular disease (OR = 2.76, 95% CI = 1.09-7.01). CONCLUSIONS: Limited functional health literacy was independently associated with obstructive sleep apnea (OSA), OSA diagnosis, lifestyle factors and comorbidities, highlighting the importance of developing and promoting national disease-specific health literacy policies.en
dc.publisherAmerican Academy of Sleep Medicineen
dc.rightsCopyright © 2014 Associated Professional Sleep Societies, LLC. Published by American Academy of Sleep Medicine.en
dc.subjectSleep apnea
dc.subjectSleep study
dc.subjectHealth literacy
dc.titleThe relationship between functional health literacy and obstructive sleep apnea and its related risk factors and comorbidities in a population cohort of menen
dc.rights.holderAssociated Professional Sleep Societies, LLC.en
local.contributor.authorOrcidLookupMcEvoy, Ronald Douglas:

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