Underdiagnosis of sleep apnea syndrome in U.S. communities

被引：299

作者：

Kapur V. ^{[1
]}

Strohl K.P. ^{[2
,7
]}

Redline S. ^{[3
]}

Iber C. ^{[4
]}

O'Connor G. ^{[5
]}

Nieto J. ^{[6
]}

机构：

[1] Department of Medicine, University of Washington, Seattle, WA

[2] Department of Medicine, Veterans Administration Medical Center, Case Western Reserve University, Cleveland, OH

[3] Department of Pediatrics, Case Western Reserve University, Cleveland, OH

[4] Department of Medicine, University of Minnesota, School of Medicine, Minneapolis, MN

[5] Department of Medicine, Boston University, School of Medicine, Boston, MA

[6] Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD

[7] Veterans Administration Medical Center, Cleveland, OH 44122

来源：

Sleep and Breathing | 2002年 / 6卷 / 2期

关键词：

Cardiovascular risk; Clinical diagnosis; Prevalence; Sleep apnea;

D O I：

10.1007/s11325-002-0049-5

中图分类号：

学科分类号：

摘要：

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.

引用

页码：49 / 54

页数：5

共 13 条

[1]

Sleep-related breathing disorders in adults: Recommendations for symptom definition and measurement techniques in clinical research, Sleep, 22, pp. 667-689, (1999)

[2]

Young T., Evans L., Finn L., Palta M., Estimation of clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women, Sleep, 20, pp. 705-706, (1997)

[3]

Dement W.C., Netzer N.C., Primary care: Is it the setting to address sleep disorders?, Sleep Breathing, 4, pp. 1-6, (2000)

[4]

Quan S.F., Howard B.V., Iber C., Kiley J.P., Nieto F.J., O'Connor G.T., Rapoport D.M., Redline S., Robbins J., Samet J.M., Wahl P.W., The Sleep Health Study: Design, rationale, and methods, Sleep, 20, pp. 1077-1085, (1997)

[5]

Young T., Palta M., Dempsey J., Skatrud J., Weber S., Badr S., The occurrence of sleep-disordered breathing among middle-aged adults, N. Engl. J. Med, 328, pp. 1230-1235, (1993)

[6]

Strohl K.P., Redline S., Recognition of obstructive sleep apnea, Am. J. Respir. Crit. Care Med, 154, pp. 279-289, (1996)

[7]

Bradley D.T., Young T., Strohl K.P., ATS/ASDA statement on health outcomes research in sleep apnea, Am. J. Respir. Crit. Care Med. Sleep, 157, pp. 335-341, (1998)

[8]

Newman A.B., Nieto F.J., Guidry U., Lind B.K., Redline S., Shahar E., Pickering T.G., Quan S.F., The relationship of sleep disordered breathing to cardiovascular disease risk factors

[9]

the Sleep Heart Health Study, Am. J. Epidemiol, 54, pp. 50-59, (2001)

[10]

Gottlieb D.J., Yao Q., Redline S., Ali T., Mahowald M.W., Does snoring frequency predict sleepiness independently of apnea and hypopnea?, Am. J. Respir. Crit. Care Med, 162, pp. 1512-1517, (2000)

← 1 2 →