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Knowledge and attitude of primary care physicians towards obstructive sleep apnea in the Middle East and North Africa region



Sleep disorders are highly prevalent in primary care. Obstructive sleep apnea (OSA) is one of the most common sleep disorders in the world, and it is estimated that only 10 to 20% of OSA cases are diagnosed. Primary care physicians (PCP) play an important role in screening for OSA. Knowledge of sleep disorders among PCP varies widely and has been generally reported as low. In this study, we aimed to assess the knowledge and attitudes towards OSA among primary care physicians in the Middle East and North Africa regions.


A cross-sectional study using the Obstructive Sleep Apnea Knowledge and Attitudes (OSAKA) self-administered questionnaire was distributed to PCP attending the Lebanese Society of Family Medicine annual conference, the Lebanese Society of Internal Medicine annual conference, and World Organization of Family Doctors (WONCA) East Mediterranean region conference.


Of 300 physicians approached, 256 (85%) completed the questionnaires. The range of possible scores was 0 to 18. The mean total knowledge score with standard deviation (SD) was 12.6 (2.5). Internal medicine specialists showed a higher mean knowledge score of 14.1 (2.3) compared to general/family medicine specialists 12.4 (2.4) and other specialties 11.9 (2.8), p = 0.001. Though 78% of all physicians felt confident in identifying patients with OSA, only 26% felt confident in managing patients with continuous positive airway pressure. Overall, there was a weak positive correlation between knowledge and attitude.


There were gaps in knowledge and attitudes regarding managing patients with OSA. Training in managing patients with OSA is needed.

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Author information




HK and GA contributed to the study conception and design. HK performed the literature review and initial manuscript write-up. GA contributed to the literature review and initial manuscript write up. Data collection, analysis, and results write-up were performed by HK, HT, and RH. All the authors contributed to the discussion, critically reviewed, and advised on each draft. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Georges Assaf.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the American University of Beirut Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Al-Khafaji, H., Bilgay, I.B., Tamim, H. et al. Knowledge and attitude of primary care physicians towards obstructive sleep apnea in the Middle East and North Africa region. Sleep Breath 25, 579–585 (2021).

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  • Obstructive sleep apnea
  • Sleep disorders
  • Knowledge
  • Attitudes
  • Primary care