Gaihong Zheng,1 Qiong Ou,2,3 Guangliang Shan,4 Yaoda Hu,4 Miaochan Lao,3 Jiaoying Tan,3 Tong Feng,3 Weixin Zhan,3 Ruohan Zhou,3 Ranxu Zhang,3 Shuhe Wu1 

1Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, People’s Republic of China; 2Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangzhou, Guangdong, 510080, People’s Republic of China; 3Sleep Center, Department of Respiratory and Critical Care Medicine, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, People’s Republic of China; 4Department of Epidemiology & Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, 100000, People’s Republic of China

Correspondence: Qiong Ou, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences, No. 106 Zhongshan Road, Yuexiu District, Guangzhou City, Guangdong Province, People’s Republic of China, Tel +86-13609717251, Email ouqiong2776@hotmail.com

Objective: Sleep-disordered breathing (SDB) poses a substantial health burden. It is often marked by patients’ low awareness and poor treatment-seeking. While age, obesity, and genetics are known risk factors, limited studies suggest that socioeconomic status, including educational level, may also affect its prevalence. However, the exact relationship remains unclear. This study aims to explore the link between educational level and SDB prevalence in Chinese community-dwelling individuals and its impact on medical behavior.
Patients and Methods: This cross - sectional study analyzed data from 3,717 residents in the Guangdong cohort. Binary logistic regression was used for multivariable analysis. The product - of - coefficients method was applied to analyze potential mediating effects of education level on SDB through lifestyle and BMI.
Results: The prevalence of SDB was 29.7%, 33%, 29.2%, 30.5% and 31.5% in the illiterate, primary school, junior high school, high school and university or above education groups, respectively, with no significant difference (P=0.580).After further adjustment for age, gender, and marital status, the results showed that education level had no significant impact on the risk of SDB in the population (P> 0.05). Mediation analysis showed that education level had an indirect effect on SDB through BMI and smoking(P< 0.0001). The rates of SDB consultation among the five groups with different education levels were 2.8%, 4.4%, 3.7%, 3.7%, and 3.9%, respectively, with no significant difference (P=0.981).
Conclusion: In Chinese community - dwelling individuals, SDB is present across all education levels. BMI and smoking may influence this. SDB patients overall have low consultation rates. As medical behavior for SDB does not differ much across education levels, disease education and intervention for SDB should target all education groups.

Keywords: educational attainment, factor, consultation rates, mediation