Abstract：
OBJECTIVE: Understanding disease prevalence can inform treatment and resource needs across populations. This study aimed to identify the prevalence of sleep apnea (OSA) among veterans and nonveterans.
METHODS: The national Comparative Health Assessment Interview Study, cross-sectional survey using probability-based sampling frames.
METHODS: Surveys completed by Internet or phone.
METHODS: 15,166 veterans (40% response rate) and 4,654 nonveterans (57% response rate).
METHODS: Self-report of healthcare provider-based diagnosis of OSA.
METHODS: Calculation of prevalence of OSA using statistical weighting to allow for direct comparison between veterans and nonveterans. Secondary analyses evaluated OSA by deployment status among veterans and compared average age of OSA diagnosis and differences in OSA prevalence among veterans and nonveterans stratified by gender, marital status, race/ethnicity, and posttraumatic stress disorder diagnosis.
RESULTS: OSA diagnosis was more than twice as prevalent among veterans (21%, 95% CI 20%-22%) than nonveterans (9%, 95% CI 8%-10%; aOR: 2.56, 95% CI 2.22-2.95, P < .001). Deployment was associated with higher odds of OSA among veterans (aOR: 1.64, 95% CI 1.43-18.7, P < 001.) Veterans were diagnosed with OSA on average 5 years earlier than nonveterans.
CONCLUSIONS: Veterans have a high prevalence rate of OSA, highlighting the importance of veterans\' access to treatment. OSA is likely underdiagnosed in nonveterans, particularly among racial/ethnic minoritized groups. Future research should investigate disparities in access to diagnostic testing for racial/ethnic minority nonveterans and/or risk factors for OSA among racial/ethnic minority veterans. The increased odds of OSA among those with PTSD highlights in the importance of early referral for OSA testing by providers as well as development of trauma-informed strategies to promote OSA treatment adherence. Limitations include a bias toward underestimation of true disease prevalence due to self-report of diagnosis.
METHODS: The national Comparative Health Assessment Interview Study, cross-sectional survey using probability-based sampling frames.
METHODS: Surveys completed by Internet or phone.
METHODS: 15,166 veterans (40% response rate) and 4,654 nonveterans (57% response rate).
METHODS: Self-report of healthcare provider-based diagnosis of OSA.
METHODS: Calculation of prevalence of OSA using statistical weighting to allow for direct comparison between veterans and nonveterans. Secondary analyses evaluated OSA by deployment status among veterans and compared average age of OSA diagnosis and differences in OSA prevalence among veterans and nonveterans stratified by gender, marital status, race/ethnicity, and posttraumatic stress disorder diagnosis.
RESULTS: OSA diagnosis was more than twice as prevalent among veterans (21%, 95% CI 20%-22%) than nonveterans (9%, 95% CI 8%-10%; aOR: 2.56, 95% CI 2.22-2.95, P < .001). Deployment was associated with higher odds of OSA among veterans (aOR: 1.64, 95% CI 1.43-18.7, P < 001.) Veterans were diagnosed with OSA on average 5 years earlier than nonveterans.
CONCLUSIONS: Veterans have a high prevalence rate of OSA, highlighting the importance of veterans\' access to treatment. OSA is likely underdiagnosed in nonveterans, particularly among racial/ethnic minoritized groups. Future research should investigate disparities in access to diagnostic testing for racial/ethnic minority nonveterans and/or risk factors for OSA among racial/ethnic minority veterans. The increased odds of OSA among those with PTSD highlights in the importance of early referral for OSA testing by providers as well as development of trauma-informed strategies to promote OSA treatment adherence. Limitations include a bias toward underestimation of true disease prevalence due to self-report of diagnosis.
摘要：
目的：了解疾病流行情况可以为不同人群的治疗和资源需求提供信息。这项研究旨在确定退伍军人和非退伍军人中睡眠呼吸暂停（OSA）的患病率。
方法：国家比较健康评估访谈研究，使用基于概率的抽样框架进行横断面调查。
方法：通过互联网或电话完成的调查。
方法：15,166名退伍军人（40%反应率）和4,654名非退伍军人（57%反应率）。
方法：基于医疗保健提供者的OSA诊断的自我报告。
方法：使用统计加权计算OSA的患病率，以便在退伍军人和非退伍军人之间进行直接比较。次要分析通过退伍军人的部署状态评估OSA，并比较OSA诊断的平均年龄以及按性别分层的退伍军人和非退伍军人之间OSA患病率的差异，婚姻状况,种族/民族,和创伤后应激障碍的诊断。
结果：OSA诊断是退伍军人的两倍多（21%，95%CI20%-22%)比非退伍军人(9%，95%CI8%-10%；OR：2.56，95%CI2.22-2.95，P<.001）。退役军人中OSA的发生几率较高(aOR:1.64,95%CI1.43-18.7,P<001。)退伍军人被诊断为OSA平均比非退伍军人早5年。
结论：退伍军人OSA患病率高，强调退伍军人获得治疗的重要性。OSA可能在非退伍军人中诊断不足，特别是在种族/族裔少数族裔群体中。未来的研究应调查种族/少数民族非退伍军人的诊断测试和/或种族/少数民族退伍军人中OSA的危险因素的差异。PTSD患者中OSA的几率增加突出表明，提供者早期转诊OSA测试的重要性以及制定创伤知情策略以提高OSA治疗依从性。局限性包括由于诊断的自我报告而倾向于低估真实疾病患病率。
方法：国家比较健康评估访谈研究，使用基于概率的抽样框架进行横断面调查。
方法：通过互联网或电话完成的调查。
方法：15,166名退伍军人（40%反应率）和4,654名非退伍军人（57%反应率）。
方法：基于医疗保健提供者的OSA诊断的自我报告。
方法：使用统计加权计算OSA的患病率，以便在退伍军人和非退伍军人之间进行直接比较。次要分析通过退伍军人的部署状态评估OSA，并比较OSA诊断的平均年龄以及按性别分层的退伍军人和非退伍军人之间OSA患病率的差异，婚姻状况,种族/民族,和创伤后应激障碍的诊断。
结果：OSA诊断是退伍军人的两倍多（21%，95%CI20%-22%)比非退伍军人(9%，95%CI8%-10%；OR：2.56，95%CI2.22-2.95，P<.001）。退役军人中OSA的发生几率较高(aOR:1.64,95%CI1.43-18.7,P<001。)退伍军人被诊断为OSA平均比非退伍军人早5年。
结论：退伍军人OSA患病率高，强调退伍军人获得治疗的重要性。OSA可能在非退伍军人中诊断不足，特别是在种族/族裔少数族裔群体中。未来的研究应调查种族/少数民族非退伍军人的诊断测试和/或种族/少数民族退伍军人中OSA的危险因素的差异。PTSD患者中OSA的几率增加突出表明，提供者早期转诊OSA测试的重要性以及制定创伤知情策略以提高OSA治疗依从性。局限性包括由于诊断的自我报告而倾向于低估真实疾病患病率。
