Prevalence of Diagnosed Obstructive Sleep Apnea in the United States 2013-2016: Insured Patients Actively Seeking Care
Background: The prevalence of obstructive sleep apnea (OSA) has not been assessed within the United States (US) in over adecade. Objectives:From 2013 to 2016, we calculated annual 2-year limited duration prevalence of diagnosed OSA in a large (~66million), geographically diverse insured population. We evaluated trends by age and sex; and assessed positive airway pressure (PAP) use and excessive sleepiness (hypersomnia diagnosis, or prescriptions for stimulant or wake-promoting agent [WPA]). Methods:Overall and age/sex specific prevalence per 100 insured persons was calculated on an annual basis. The cohort was defined to include those with medical and pharmacy claims activity. To mitigate rule-out diagnoses,cases had to have ≥2 medical claims for OSA within a 6-month period. Overall annual prevalences were directly standardized to the US population using 2016 US age and sex Census weights. Results: Annualage/sex adjusted prevalence of OSA increased from 2.4% in 2013 to 3.4% in 2016. OSA patients had a mean age of 58 years and there was a ≈2:1 male:female prevalence ratio. OSA patients with PAP claims increased from 42.2% to 44.1% over the study period. Excessive sleepiness (hypersomnia or stimulant/WPA prescriptions) for patients with or without PAP use both declined by ≈ 4% -5%. Conclusions:Diagnosed OSA prevalence and PAP use among insured members with claims activity increased during 2013-2016 while clinical markers of excessive sleepiness declined. Males had a much higher prevalence of OSA than females.