OSA Is Vastly Underdiagnosed in Older Americans

Obstructive sleep apnea (OSA) is significantly underdiagnosed among older Americans, according to new findings.

Researchers arrived at this conclusion after evaluating 1052 community-dwelling Medicare beneficiaries aged 65 years and older who participated in the National Health and Aging Trends Study (NHATS).
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Participants answered specific questions about sleep disturbances, including items that resembled critical elements of the STOP-Bang questionnaire, a validated OSA risk assessment tool.

Furthermore, the researchers assessed the proportion of older Americans with OSA risk who received evaluations with home or in-laboratory sleep studies, OSA diagnosis, and OSA treatment.

Results indicated that approximately 56% of NHATS participants had a high risk for OSA, but only 8% of participants with high risk were tested for OSA.

Of the 8% who were tested, 94% received a diagnosis of OSA. Positive airway pressure treatment was prescribed for 82% of patients with an OSA diagnosis.

“Evidence from this nationally representative sample of community‐dwelling Medicare beneficiaries suggests that high OSA risk is common but seldom investigated,” the researchers wrote. “When investigated, OSA is almost always confirmed and usually treated.”

“These findings suggest a significant gap in OSA assessment for older Americans that could have public health implications,” they concluded.

—Christina Vogt

Reference:

Braley TJ, Dunietz GL, Chervin RD, Lisabeth LD, Skolarus LE, Burke JF. Recognition and diagnosis of obstructive sleep apnea in older Americans [Published online May 2018]. J Am Geriatr Soc. https://doi.org/10.1111/jgs.15372

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