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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1296-1302 |
| Number of pages | 7 |
| Journal | Journal of the American Geriatrics Society |
| Volume | 66 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 2018 |
Funding
The authors would like to thank Brady T. West for his statistical expertise, Maureen E. Skehan for her data management assistance, and Chunyang Feng for her assistance with data acquisition and management. Conflict of Interest: Dr. Braley conducts investigator-initiated studies funded by the National Multiple Sclerosis Society, the American Sleep Medicine Foundation, and the Patient-Centered Outcomes Research Institute and recently completed a sleep apnea clinical trial that received material support, but no financial support, from Biogen-Idec. She is also named in a provisional patent held by the University of Michigan concerning treatment for sleep apnea. Dr. Chervin is named in or has developed patented and copyrighted materials owned by the University of Michigan designed to assist with assessment or treatment of sleep disorders. Dr. Chervin serves on the boards of the American Academy of Sleep Medicine (currently as President), the International Pediatric Sleep Society, and the nonprofit Sweet Dreamzzz. He is an editor for UpToDate, has edited a book for Cambridge University Press, and has consulted for Zansors. Author Contributions: Braley: study conception and design, analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, final approval of version to be published. Dunietz: acquisition, analysis, and interpretation of data; drafting the manuscript and revising it critically for important intellectual content, final approval of version to be published. Chervin, Lisabeth, Skolarus: analysis and interpretation of data, revising manuscript critically for important intellectual content, final approval of version to be published. Burke: study conception and design, analysis and interpretation of data, revising manuscript critically for important intellectual content, final approval of version to be published. Sponsor's Role: This work was supported by an American Sleep Medicine Foundation Strategic Research Award 115-SR-15 (Braley). This work was also supported in part by the National Institute of Minority Health and Health Disparities (R01 MD008879); National Institute of Aging, National Institutes of Health (NIH) (U01AG032947); National Institute of Neurological Disorders and Stroke (NINDS), NIH (K23 NS073685; Skolarus); and NINDS, NIH (K08NS082597; Burke). Dr. Dunietz' work for this project was supported by NINDS, NIH (T32 NS007222). Conflict of Interest: Dr. Braley conducts investigator-initiated studies funded by the National Multiple Sclerosis Society, the American Sleep Medicine Foundation, and the Patient-Centered Outcomes Research Institute and recently completed a sleep apnea clinical trial that received material support, but no financial support, from Biogen-Idec. She is also named in a provisional patent held by the University of Michigan concerning treatment for sleep apnea. Dr. Chervin is named in or has developed patented and copyrighted materials owned by the University of Michigan designed to assist with assessment or treatment of sleep disorders. Dr. Chervin serves on the boards of the American Academy of Sleep Medicine (currently as President), the International Pediatric Sleep Society, and the nonprofit Sweet Dreamzzz. He is an editor for UpToDate, has edited a book for Cambridge University Press, and has consulted for Zansors. Sponsor’s Role: This work was supported by an American Sleep Medicine Foundation Strategic Research Award 115-SR-15 (Braley). This work was also supported in part by the National Institute of Minority Health and Health Disparities (R01 MD008879); National Institute of Aging, National Institutes of Health (NIH) (U01AG032947); National Institute of Neurological Disorders and Stroke (NINDS), NIH (K23 NS073685; Skolarus); and NINDS, NIH (K08NS082597; Burke). Dr. Dunietz’ work for this project was supported by NINDS, NIH (T32 NS007222).
Keywords
- Medicare
- National Health and Aging Trends Study
- STOP-BANG
- obstructive sleep apnea
- polysomnography
ASJC Scopus subject areas
- Geriatrics and Gerontology
