OSA Knowledge and Attitudes

This study was approved by the institutional review board (IRB) of King Fahad Military Medical Complex – Dhahran, Saudi Arabia (IRB number AFHER-IRB-2020-014). The participants’ consents were obtained by electronic consent methods. This survey-based cross-sectional study utilized a previously validated questionnaire called the “OSAKA questionnaire.” The OSAKA questionnaire is composed of 18 items that are used to assess one’s knowledge and 5 items to assess one’s attitudes concerning dealing with OSA. An online questionnaire was sent between July and August 2020 via email and WhatsApp instant messaging to the Saudi board’s ORL trainee residents, including those in their second year of residency (R2) to their final year of residency (R5) (n = 185). First- year residency trainees were not included, as they were rotating in preparatory rotations and had no previous exposure to ORL clinical training. The survey was conducted anonymously. Along with the OSAKA questionnaire, sociodemographic data and data about previous exposure to sleep practices were also collected. The sociodemographic data included age, gender, level of training, years of ORL practice including residency, year of graduation from medical college, and residency program region (by province). Data reflecting previous exposure to sleep practices were also collected, such as the frequency of exposure to diagnosed OSA patients, patients susceptible to OSA, polysomnography data, obese patients, and surgery directed to treat OSA. We also collected data on trainees’ self-reported awareness and previous consideration of other sleep disorders during their clinical training (such as inadequate sleep hygiene, insomnia, narcolepsy, and periodic limb movement disorder) as well as awareness of other related disorders (such as overlap syndrome and obesity hypoventilation syndrome). We considered those who answered that they were “aware of other sleep disorders” and who gave examples of other sleep disorders as the aware group. The knowledge section of the OSAKA questionnaire was assessed by calculating the total true responses for the knowledge section. The total knowledge score was calculated out of 18. The attitude section of the OSAKA questionnaire consisted of five questions (two for importance and three for confidence). It was calculated out of 5 for each question (the responses “extremely important” and “strongly agree” were scored as scores of 5). The total attitude score was calculated using a maximum score of 25, reflecting the sum score of the five attitude elements. For the confidence questions, we considered those who answered “agree” and “strongly agree” as the confident group in identifying OSA-susceptible patients and managing OSA patients. Exposure to each of the aforementioned clinical exposure items was divided and classified as either no exposure or any number of exposure incidences.