title: Sleep Disorders in Aboriginal and Torres Strait Islander People and Residents of Regional and Remote Australia.
abstract: OBJECTIVE
  To compare the use of sleep diagnostic tests, the risks, and cofactors, and outcomes of the care of Indigenous and non-indigenous Australian adults in regional and remote Australia in whom sleep related breathing disorders have been diagnosed.
  
  
  METHODS
  A retrospective cohort study of 200 adults; 100 Aboriginal and Torres Strait Islander and 100 non-indigenous adults with a confirmed sleep related breathing disorder diagnosed prior to September 2011 at Alice Springs Hospital and Cairns Hospital, Australia.
  
  
  RESULTS
  Results showed overall Indigenous Australians were 1.8 times more likely to have a positive diagnostic sleep study performed compared with non-indigenous patients, 1.6 times less likely in central Australia and 3.4 times more likely in far north Queensland. All regional and remote residents accessed diagnostic sleep studies at a rate less than Australia overall (31/100,000/y (95% confidence interval, 21-44) compared with 575/100,000/y).
  
  
  CONCLUSIONS
  The barriers to diagnosis and ongoing care are likely to relate to remote residence, lower health self-efficacy, the complex nature of the treatment tool, and environmental factors such as electricity and sleeping area. Indigeneity, remote residence, environmental factors, and low awareness of sleep health are likely to affect service accessibility and rate of use and capacity to enhance patient and family education and support following a diagnosis. A greater understanding of enablers and barriers to care and evaluation of interventions to address these are required.
  
  
  CONCLUSIONS
  A commentary on this article appears in this issue on page 1255.
authors.affiliation: College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.|Centre for Nursing and Midwifery Research, James Cook University, Cairns, Queensland, Australia.
authors.forename: Cindy E
authors.initials: CE
authors.lastname: Woods
authors.affiliation: Alice Springs Hospital, Alice Springs, Northern Territory, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: McPherson
authors.affiliation: Alice Springs Hospital, Alice Springs, Northern Territory, Australia.
authors.forename: Erik
authors.initials: E
authors.lastname: Tikoft
authors.affiliation: Centre for Nursing and Midwifery Research, James Cook University, Cairns, Queensland, Australia.
authors.forename: Kim
authors.initials: K
authors.lastname: Usher
authors.affiliation: Alice Springs Hospital, Alice Springs, Northern Territory, Australia.
authors.forename: Fariborz
authors.initials: F
authors.lastname: Hosseini
authors.affiliation: Cairns Hospital, Cairns, Queensland, Australia.
authors.forename: Janine
authors.initials: J
authors.lastname: Ferns
authors.affiliation: Alice Springs Hospital, Alice Springs, Northern Territory, Australia.|Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Hubertus
authors.initials: H
authors.lastname: Jersmann
authors.affiliation: Alice Springs Hospital, Alice Springs, Northern Territory, Australia.|Royal Adelaide Hospital, Adelaide, South Australia, Australia.|University of Adelaide, Adelaide, South Australia.
authors.forename: Ral
authors.initials: R
authors.lastname: Antic
authors.affiliation: College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.|Alice Springs Hospital, Alice Springs, Northern Territory, Australia.|Baker IDI Central Australia, Alice Springs, Northern Territory, Australia.
authors.forename: Graeme Paul
authors.initials: GP
authors.lastname: Maguire
mesh_terms: D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
keywords: Australia; indigenous population; obstructive sleep apnoea; polysomnography; sleep