Chest
Clinical InvestigationsSleep and BreathingWhat Are Obstructive Sleep Apnea Patients Being Treated for Prior to This Diagnosis?
Section snippets
Materials and Methods
This study was undertaken in the Canadian province of Manitoba. All residents have access to government-funded health-care services, including physician visits and hospitalizations. Each physician visit generates a standardized claim form submitted to a central government agency (Manitoba Health), which then renders payment. Manitoba Health maintains a detailed computer database, the Manitoba Health database (MHdb), tracking all visits to physicians, hospitalizations, and outpatient surgeries
Results
Table 1 shows the characteristics of the OSAS patients. They were, on average, obese and had symptomatic OSAS. There were more men than women, reflecting the gender distribution of this disorder.3 The female OSAS patients were significantly older (p < 0.001) and more obese (p < 0.001) than the male patients; however, the male patients had higher apnea indexes (p < 0.001) and Epworth Sleepiness Scale (ESS) scores (p = 0.013) than the female patients.
Discussion
We found that prior to diagnosis of OSAS (and not necessarily prior to disease onset), sleep apnea patients more frequently received diagnoses of a variety of other conditions compared to the control subjects. These include hypertension, congestive heart failure, cardiac arrhythmias, cardiovascular disease, obstructive airways disease, and depression. This indicates that apnea patients are more ill than control subjects, and also suggests that some may have incorrect diagnoses and may be
Conclusion
We found that in the years leading up to diagnosis of OSAS, patients with sleep apnea are more likely than control subjects to be treated for cardiovascular diseases, chronic obstructive airways disease, and depression. Depression appears to be treated differently in sleep apnea patients (with higher usage of antidepressant medications) than in the general population. Age and BMI are significant predictors of many of the cardiovascular diagnoses in OSAS patients, while other variables such as
References (21)
- et al.
Mortality and apnea index in obstructive sleep apnea: experience in 385 male patients
Chest
(1988) Physiological and metabolic consequences of obesity
Metabolism
(1995)- et al.
Social and economic effects of body weight in the United States
Am J Clin Nutr
(1996) Daytime sleepiness, snoring, and obstructive sleep apnea: the Epworth Sleepiness Scale
Chest
(1993)- et al.
The use of health-care resources in obesity-hypoventilation syndrome
Chest
(2001) - et al.
Why should sleep apnea be diagnosed and treated?
Clin Pulm Med
(1994) - et al.
The occurrence of sleep-disordered breathing among middle-aged adults
N Engl J Med
(1993) - et al.
Snoring and breathing pauses during sleep: telephone interview survey of a United Kingdom sample
BMJ
(1997) - et al.
Health effects of obstructive sleep apnoea and the effectiveness of continuous positive airway pressure: a systematic review of the research evidence
BMJ
(1997) - et al.
Utilization of health care services in patients with severe obstructive sleep apnea
Sleep
(1996)
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Supported in part by National Institutes of Health grant No. R01 HL63342–01A1.