A population-based estimate of the health care burden of obstructive sleep apnea using a STOP-BAG questionnaire in South Carolina

Abstract

Study Objectives: Population based estimates of obstructive sleep apnea (OSA) frequency and health impact are incomplete. The aim of this study was to determine the prevalence of risk factors for physician and sleep study diagnosed OSA among individuals in a state-based surveillance program Methods: Using questions inserted into the 2016 (n = 5,564) and 2017 (n = 10,884) South Carolina Behavioral Risk Factor Surveillance System of the Centers for Disease Control and Prevention, we analyzed the prevalence of physician diagnosed OSA and associated comorbidities. The validated STOP-BANG questionnaire without neck circumference (STOP-BAG) defined populations at moderate risk (score 3-4) and high risk (score 5-7). Statistical analysis using weighted prevalence and means and their 95% confidence intervals (CI) thus reflect population estimates of disease burden. Results: The population-based prevalence of physician diagnosed OSA in South Carolina was 9.7% (95% CI: 9.0-10.4). However, the populations with moderate risk (18.5%, 95% CI: 17.3-19.8) and high risk (25.5%, 95% CI: 23.9-27.1) for OSA, as determined by the STOP-BAG questionnaire, were much higher. Compared to those at low risk for OSA, those at high risk were more often diagnosed with coronary heart disease, stroke, asthma, skin cancer, other cancers, chronic obstructive pulmonary disease, arthritis, depression, kidney disease, and diabetes (all P < .001). Conclusions: OSA is common and strongly associated with major comorbidities. As such, this public health crisis warrants more diagnostic and therapeutic attention. The STOP-BAG questionnaire provides a public health platform to monitor this disease.

Association between Obstructive Sleep Apnea and Chronic Kidney Disease According to Sex, Long Working Hours: The Korean National Health and Nutrition Examination Survey (2019–2020)

“…Additionally, the prevalence of high risk, defined by STOP-BAG scores of 5 or higher, was found to be 15.2% of the population. This finding aligns with a previous United States study [ 23 ] that acknowledged the difficulty in determining the prevalence of undiagnosed individuals in the population. Moreover, the study revealed that 44% of the population, as identified by the STOP-BANG score while the current diagnosis rate was only 10% and these results underscore the magnitude of the public health crisis, representing a significant and urgent issue of epidemic proportions [ 23 ].…”

“…This finding aligns with a previous United States study [ 23 ] that acknowledged the difficulty in determining the prevalence of undiagnosed individuals in the population. Moreover, the study revealed that 44% of the population, as identified by the STOP-BANG score while the current diagnosis rate was only 10% and these results underscore the magnitude of the public health crisis, representing a significant and urgent issue of epidemic proportions [ 23 ]. Our previous study demonstrated a positive association between higher scores on the STOP-BAG instrument and an increased risk of multimorbidity [ 24 ].…”

Factors Related to Obstructive Sleep Apnea According to Age: A Descriptive Study

“…In addition, unlike the elderly, middle-aged people, who are at high risk of OSA, often have stressful and suicidal thoughts. These findings are consistent with those of previous studies [33][34][35]. However, these studies did not analyze middle-aged and adults separately; hence, further research is required.…”

Obstructive sleep apnea related to mental health, health-related quality of life and multimorbidity: A nationwide survey of a representative sample in Republic of Korea

“…In the US population, men who snore or stop breathing more than 5 nights/week have the strongest association with probable major depression [ 27 ]. A previous study showed that a high OSA risk determined by the STOP-BANG questionnaire was more often diagnosed with depression than with low risk for 16,448 in South Carolina, United States [ 26 ]. Psychological stress was high in patients with OSA, and the presence of OSA, not severity, and was related to depression and anxiety in 44 untreated participants with OSA and 57 health controls in a study in the United States [ 28 ].…”