Ambulatory Visits and Comorbidity in Obstructive Sleep Apnea

Abstract

Objective: 1) Understand the epidemiology of obstructive sleep apnea (OSA) ambulatory office visits in the US. 2) Quantify and learn about the prevalence of comorbid illnesses that are likely to occur in the setting of OSA.

Method: From the 2008-2009 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, adult cases with a diagnosis of OSA were extracted. The epidemiology of OSA was determined. The prevalence of comorbid priority illnesses (obesity, asthma, cerebrovascular disease, depression, hypertension, and ischemic heart disease) was also determined.

Results: There were an estimated 8.1 ± 2.4 million office visits with a diagnosis of OSA (60 ± 3.2% male; mean age, 56.4 ± 0.9 years). There were 389 ± 49 thousand visits to otolaryngologists for OSA. Comorbid illnesses were: obesity (23.8 ± 5.2%), asthma (14.3 ± 3.0%), cerebrovascular disease (2.5 ± 1.5%), depression (23.2 ± 2.6%), hypertension 53.8 ± 3.9%), and ischemic heart disease (10.3 ± 3.0%). Adjusting for age, sex, ethnicity, obesity and race, statistically significant increased odds for the presence of obesity (3.6, P < .001), asthma (2.7, P < .001), depression (2.5, P < .001), and hypertension (2.0, P < .001) with obstructive sleep apnea were noted. Increased odds for cerebrovascular disease and ischemic heart disease were not identified (P > .083).

Conclusion: OSA is a common diagnosis in ambulatory and otolaryngologic care. It is associated with a significantly increased prevalence of several key priority healthcare conditions in the United States. Healthcare providers should be aware of these associations understanding the potentially broad impact of OSA on general health.