AUTHOR=Giombi Francesco , Cerri Luca , Cerasuolo Michele , Pace Gian Marco , Sandri Giulio , Braghiroli Alberto , Mercante Giuseppe , Spriano Giuseppe , Cucchi Michele , Aliberti Stefano , Heffler Enrico , Canonica Walter , Paoletti Giovanni , Keber Enrico , Giua Corrado ,  SIFAC Group , Malvezzi Luca 

TITLE=Community pharmacies in early detection of obstructive sleep apnea: findings from a nationwide survey

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1712922

DOI=10.3389/fpubh.2025.1712922

ISSN=2296-2565

ABSTRACT=IntroductionObstructive sleep apnea (OSA) is a highly prevalent, yet underdiagnosed sleep disorder associated with cardiovascular, metabolic, and neurocognitive morbidity, as well as impaired quality of life. Limited access to diagnostics, low public awareness, and underreporting of symptoms contribute to a substantial gap in detection. Community pharmacies, given their accessibility and frequent interaction with patients managing multiple comorbidities, represent a promising but underexplored setting for identifying individuals at high risk.ObjectiveTo investigate the feasibility of pharmacy-based screening for OSA and to provide preliminary insights into the prevalence of at-risk individuals among pharmacy clients.MethodsA cross-sectional study was conducted in 22 Italian community pharmacies, where participants completed a three-section questionnaire recording demographic data, the Berlin Questionnaire (BQ) for OSA screening and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality assessment. Multivariate regression was performed to explore the association between poor questionnaire outcomes, demographic variables, and ongoing medication use. A sensitivity analysis was conducted to minimize the risk of bias.ResultsA total of 301 individuals were included (females: n = 169/301, 56.15%). One-hundred-sixteen subjects (38.5%, n = 301) scored positively in at least two categories of the BQ and were hence classified as at-risk. At sensitivity analysis, BMI (OR = 1.15, 95%CI: 1.07–1.24, p < 0.001), and ongoing antihypertensive medications (OR = 2.02, 95%CI: 1.78–3.11, p = 0.002) were associated with poor BQ outcome. A significantly higher PSQI score was observed compared to previously reported values in healthy individuals. However, no significant associations were observed between poor sleep quality and patients’ demographics, or ongoing medication use.ConclusionCommunity pharmacies can serve as a valuable setting for the early identification of individuals at risk for sleep-related breathing disorders, particularly among patients with multiple comorbidities. By leveraging their accessibility and frequent patient contact, pharmacies may complement existing healthcare pathways and support efforts aimed at reducing the current diagnostic gap in OSA.