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J Am Geriatr Soc. 2018 Jul;66(7):1296-1302. doi: 10.1111/jgs.15372. Epub 2018 May 9.

Recognition and Diagnosis of Obstructive Sleep Apnea in Older Americans.

Author information

1
Sleep Disorders Center, School of Public Health, University of Michigan, Ann Arbor, Michigan.
2
Department of Neurology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
3
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.

Abstract

OBJECTIVES:

To estimate the proportion of older Americans at risk for obstructive sleep apnea (OSA) who receive OSA evaluations, diagnosis, and treatment.

DESIGN:

Cross sectional study.

SETTING:

National Health and Aging Trends Study (NHATS), Round 3 survey.

PARTICIPANTS:

Community-dwelling Medicare beneficiaries age 65 and older (N=1,052).

MEASUREMENTS:

NHATS participants were asked specific questions about sleep disturbances, including items that resembled critical elements of a validated instrument used to assess OSA risk (the STOP-Bang questionnaire). The proportion of older Americans at risk for OSA who received evaluations with home or in-laboratory sleep studies, OSA diagnosis, and OSA treatment was examined, as well as clinical, social, and demographic correlates of OSA.

RESULTS:

Of 1,052 participants who completed the sleep module, 56% (95% confidence interval (CI)=53-59%) were estimated to be at high risk of OSA. Only 8% (95% CI=5-11%) of the high-risk individuals had been tested for it. Of those tested, 94% (95% CI=87-100%) were diagnosed with OSA. Treatment with positive airway pressure was prescribed for 82% (95% CI=65-99%) of participants with an OSA diagnosis.

CONCLUSIONS:

Evidence from this nationally representative sample of community-dwelling Medicare beneficiaries suggests that high OSA risk is common but seldom investigated. When investigated, OSA is almost always confirmed and usually treated. These findings suggest a significant gap in OSA assessment for older Americans that could have public health implications.

KEYWORDS:

Medicare; National Health and Aging Trends Study; STOP-BANG; obstructive sleep apnea; polysomnography

PMID:
29744855
PMCID:
PMC6097901
[Available on 2019-07-01]
DOI:
10.1111/jgs.15372

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