Ambulatory Office Visits and Medical Comorbidities Associated with Obstructive Sleep Apnea

Objective. (1) Understand the epidemiology of obstructive sleep apnea (OSA) ambulatory office visits in the United States. (2) Quantify the prevalence of comorbid illnesses that are likely to occur in the setting of OSA. Methods. From the 2008-2009 National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Surveys, adult cases with a diagnosis of OSA were extracted. The epidemiology of OSA was determined. The prevalences of comorbid priority illnesses (obesity, asthma, cerebrovascular disease, depression, hypertension, and ischemic heart disease) were also determined. Study Design. Cross-sectional analysis of a national survey database. Setting. Ambulatory care settings in the United States. Results. There were an estimated 4.1 +/- 1.2 million annual visits with a diagnosis of OSA (60% +/- 3.2% men; mean age, 56.4 +/- 0.9 years). There were 419,000 +/- 28,000 visits annually 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 OSA were noted. Increased odds for cerebrovascular disease and ischemic heart disease were not identified (P = .725 and P = .083, respectively). Conclusion. Obstructive sleep apnea is a relatively common diagnosis in ambulatory and otolaryngologic care. It is associated with a significantly increased prevalence of several key priority health care conditions in the United States. Otolaryngologists and health care providers should be aware of these associations, understanding the potentially broad impact of OSA on general health.