title: Recognition of Sleep Apnea Is Increasing. Analysis of Trends in Two Large, Representative Databases of Outpatient Practice.
abstract: Little is known about recent trends in physician reporting of sleep apnea during outpatient practice visits.
  
  
  
  To assess trends in the frequency of adult outpatient visits for sleep apnea in the United States, the clinicians who provided those visits, and the characteristics of patients reported to have sleep apnea; and to assess whether the reporting of a diagnosis of sleep apnea varies across regions of the country as a function of body weight and insurance status.
  
  
  
  We reviewed annual stratified samples of patients identified as having sleep apnea during physician office visits in the U.S. National Ambulatory Medical Care Survey database, and during visits to hospital outpatient practices in the U.S. National Hospital Ambulatory Medical Care Survey database, between 1993 and 2010. The aggregate data set included records of 838,000 ambulatory practice visits.
  
  
  
  During this 17-year period, survey reports of a diagnosis of sleep apnea increased 14.6- fold, from 420,000 to 6.37 million per year (P = 0.0002). Thirty-three percent were reported by primary care providers, 17% by pulmonologists, and 10% by otolaryngologists. Over the period of observation, reports of a diagnosis of sleep apnea by "other groups" increased considerably (P < 0.001). The per capita rate of sleep apnea diagnoses per 1,000 persons per year differed across regions of the United States (P < 0.0001). Regions that reported a higher rate of sleep apnea appeared to be influenced by obesity (P < 0.001) and health insurance status (P < 0.005).
  
  
  
  Diagnoses of sleep apnea during outpatient visits to hospital-based and non-hospital-based practices in the United States were much more frequent in 2010 than in 1993, as reported by outpatient practice clinicians participating in national surveys. Although the majority of diagnoses of sleep apnea were reported by primary care providers, pulmonologists, and otolaryngologists (60%), there was a substantial increase in reports of sleep apnea by clinicians practicing other specialties during the study period. Reporting of a diagnosis of sleep apnea varied by obesity prevalence and health insurance status across U.S. geographic regions.
authors: 1 Department of Internal Medicine, Division of Pulmonary, Critical Care and Allergy and Immunology, and.
authors: Andrew M
authors: 0000-0001-5003-0900
authors: AM
authors: Namen
authors: 1 Department of Internal Medicine, Division of Pulmonary, Critical Care and Allergy and Immunology, and.
authors: Arjun
authors: A
authors: Chatterjee
authors: 1 Department of Internal Medicine, Division of Pulmonary, Critical Care and Allergy and Immunology, and.
authors: Karen E
authors: KE
authors: Huang
authors: 2 Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors: Steven R
authors: SR
authors: Feldman
authors: 1 Department of Internal Medicine, Division of Pulmonary, Critical Care and Allergy and Immunology, and.
authors: Edward F
authors: EF
authors: Haponik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D003710:Demography; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D009819:Office Visits; D010045:Outpatients; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: national ambulatory medical care; national hospital ambulatory medical care; obesity; recognition; sleep apnea