Health Insurance Status In Subjects At High Risk For Obstructive Sleep Apnea

Abstract Introduction Undiagnosed obstructive sleep apnea (OSA) is a major public health problem. Undiagnosed OSA can result in decreased productivity due to absenteeism, increased risk of comorbidities (cardiovascular disease, diabetes, and depression), and increased motor vehicle as well as workplace accidents. Lack of health insurance coverage can lead to undiagnosed and therefore untreated OSA. The objective of this study is to evaluate health insurance status in subjects at high-risk for OSA. Methods This is a cross-sectional, population-based study of adults 18 years and older who participated in the 2017–2018 National Health and Nutrition Examination Survey (NHANES). A modified STOP-Bang score was used to calculate OSA risk. This score included all the variables from the standard STOP-Bang questionnaire, except neck circumference, since it was not reported in the NHANES survey. Subjects were divided into two groups: those at low-risk for OSA with a modified STOP-Bang score of ≤ 3 and those at high-risk for OSA with a modified STOP-Bang score of >4. Results A total of 4,847 adult subjects were included, which represented 223,385,241 of the U.S. non-institutionalized population. Using the modified STOP-Bang score cutoff of >4, 20.9% of the sample were classified as high-risk for OSA, while 79.1% were classified as low-risk for OSA. 90% of the high-risk OSA group and 85.1% of the low-risk OSA group reported having health insurance. Sociodemographic data will also be analyzed and included. Conclusion Approximately 10% of subjects who are at high-risk for OSA reported not having health insurance. This represents over 4.6 million Americans in the non-institutionalized population. Health insurance can improve access to health care. Timely diagnosis and treatment of OSA not only can reduce morbidity and mortality, but can also reduce health care costs. Support (if any) CDC for NHANES Data.