0506 Practice Patterns of Sleep Disorders Diagnoses in a Statewide Health System: An Electronic Health Record Analysis

Abstract Introduction A substantial proportion of medical care is delivered through hospital networks and health systems. Yet relatively little is known about how sleep disorders are managed from a health systems perspective. Such insight is vital to improve population sleep health. The purpose of this study was to characterize sleep disorder practice patterns within a statewide health system. Methods The University of Maryland Medical System (UMMS) is comprised of 13 largely autonomous hospitals that function in a decentralized manner. Four UMMS hospitals feature sleep centers. In this study, patients diagnosed with sleep disorders (January 1 – December 5, 2023) were identified using the UMMS electronic health record (EPIC). Demographic information was obtained from the EHR. Sleep disorders were identified based on ICD-10 diagnostic codes assigned within the EHR. Descriptive statistics were used to characterize sleep disorder diagnoses at the system and hospital levels. Results Of UMMS patients seen during the study period, 5.8% of individuals (up to N=65,095) were diagnosed with sleep disorders. The two most common sleep disorders were obstructive sleep apnea (OSA; n=36,130 patients) and insomnia (n=20,280). Others included restless legs syndrome (n=3744), hypersomnia (n=1959), parasomnias (n=816), circadian rhythm disorders (n=532), narcolepsy (n=397), central sleep apnea (n=342), and periodic limb movement disorder (n=175). The highest numbers of sleep disorder diagnoses occurred at hospitals with sleep centers. Multiple points of care had zero diagnoses for common sleep disorders. In terms of sociodemographic characteristics, the ratio of OSA vs insomnia differed between Black and White adults. Conclusion Sleep disorders are commonly diagnosed in a statewide health system, with substantial variation between hospitals and points of care. Potential disparities were observed in the ratio of OSA vs insomnia diagnoses between Black vs White adults, suggesting possible underdiagnosis of insomnia among Black adults and an important topic for future research. Health systems leaders should consider system and hospital-level approaches including increasing provider awareness and leveraging telehealth and technology to improve outcomes for patients, providers, and health systems. Support (if any) University of Maryland, Baltimore