Prevalence of symptoms and risk of sleep apnea in primary care.
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.
Netzer
Nikolaus C
NC
The Center for Sleep Disorders Research, Case Western Reserve University, Cleveland, OH, USA.
Hoegel
Josef J
JJ
Loube
Daniel
D
Netzer
Cordula M
CM
Hay
Birgit
B
Alvarez-Sala
Rudolfo
R
Strohl
Kingman P
KP
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