title: Prevalence of symptoms and risk of sleep apnea in primary care.
abstract: BACKGROUND
  To obtain prevalence estimates for key symptoms and features that can indicate the presence of obstructive sleep apnea (OSA) in a broad range of primary care settings.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Forty offices and clinics in the United States, Germany, and Spain.
  
  
  METHODS
  Consecutive patients who were > 15 years of age, regardless of the reason for the visit.
  
  
  METHODS
  We collected demographic information, prevalence of self-reported chronic snoring, sleepiness, obesity (body mass index [BMI] > 30), hypertension, and calculation of OSA risk, and we also compared results between the United States and Europe.
  
  
  RESULTS
  There was a 78% return rate for 8,000 surveys (mean age, 51 years; age range, 15 to 98 years; 52% women). One third of participants (32%) had a high pretest probability for OSA, with a higher rate in the United States (35.8% of 3,915 participants) than in Europe (26.3% of 2,308 participants; p < 0.001; age-matched and sex-adjusted odds ratio [OR], 1.37; 95% confidence interval [CI], 1.16 to 1.61). Sleepiness (32.4% vs 11.8%, respectively; p < 0.001) followed by obesity and/or hypertension (44.8% vs 37.1%, respectively; p < 0.01) contributed to the OSA risk difference between participants in the United States and Europe, as frequent snoring and breathing pauses were similarly reported (44%). A high pretest probability for OSA was more often present in men than in women (37.9% vs 27.8%, respectively; p < 0.005; OR, 1.96; CI, 1.59 to 2.88) and in those that were obese (ie, BMI, > or = 30 kg/m(2)), a condition that is generally more common in the US population than in the European population (27.9% vs 17.2%, respectively; p < 0.01).
  
  
  CONCLUSIONS
  Primary care physicians in the United States and Europe will encounter a high demand for services to confirm or manage sleep apnea, sleepiness, and obesity.
authors.affiliation: The Center for Sleep Disorders Research, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Nikolaus C
authors.initials: NC
authors.lastname: Netzer
authors.forename: Josef J
authors.initials: JJ
authors.lastname: Hoegel
authors.forename: Daniel
authors.initials: D
authors.lastname: Loube
authors.forename: Cordula M
authors.initials: CM
authors.lastname: Netzer
authors.forename: Birgit
authors.initials: B
authors.lastname: Hay
authors.forename: Rudolfo
authors.initials: R
authors.lastname: Alvarez-Sala
authors.forename: Kingman P
authors.initials: KP
authors.lastname: Strohl
mesh_terms: D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States