Sleep Breath 2002; 06(2): 049-054
DOI: 10.1055/s-2002-32318
ORIGINAL ARTICLE

Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Underdiagnosis of Sleep Apnea Syndrome in U.S. Communities

Vishesh Kapur1 , Kingman P. Strohl2 , Susan Redline3 , Conrad Iber4 , George O'Connor5 , Javier Nieto6
  • 1Department of Medicine, University of Washington, Seattle, Washington
  • 2Department of Medicine, Veterans Administration Medical Center, Case Western Reserve University, Cleveland, Ohio
  • 3Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
  • 4Department of Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota
  • 5Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
  • 6Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland
Further Information

Publication History

Publication Date:
19 June 2002 (online)

ABSTRACT

We hypothesize that clinical recognition rates for obstructive sleep apnea-hypoapnea syndrome (OSAHS) are influenced by comorbidity and demographic factors. Data on medical disorders, symptoms of sleep disorders, and cardiovascular risk factors gathered from 15,699 individuals in the Sleep Heart Health Study were compared. Participants were classified into three groups: those with a self-reported physician diagnosis of OSAHS, those with self-reported physician-diagnosed and -treated OSAHS, and those reporting both frequent snoring and daytime sleepiness (two-symptom group). Among all participants, 4.1% reported two symptoms (range across sites: 1.55 to 7.23%), whereas 1.6% reported a physician diagnosis of OSAHS (range: 0.66 to 2.88%) and 0.6% reported physician diagnosis and treatment (range: 0.11 to 0.88%). Recognized OSAHS groups were similar to the two-symptom group in age, having a sleeping partner, measured blood pressure, total cholesterol, and race. In a logistic model that included age along with characteristics found to vary significantly among the three groups (gender, body mass index [BMI], high-density lipoprotein cholesterol levels, hypertension), only male gender and BMI were increased in those with physician-diagnosed and -treated OSAHS. We conclude that disparities (especially in women and in those with lower BMI) exist between current recognition rates for OSAHS and the estimated prevalence by symptom report across the United States.

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