Abstract
Abstract Introduction Obstructive sleep apnea (OSA) is common in individuals with metabolic syndrome (MetS) and increases risk of cardiovascular (CVD) events. Once recognized, therapeutic interventions can reduce OSA severity and associated CVD risk. Of the 25 million Americans with OSA, 80% are unaware of their disease. To facilitate and improve diagnosis of OSA, diagnostic devices for at-home OSA testing have been developed in clinical studies and approved by FDA. We evaluated an employer-sponsored healthcare outreach program and at-home OSA testing as a means of identifying individuals likely to have OSA and referring them into care. Methods Nine-hundred individuals with MetS, positive OSA Berlin questionnaire score and no prior diagnosis of OSA, as determined by annual workplace screening and health claims, were invited to participate in the sleep program. Those who agreed to participate (9.9%) received a diagnostic device for at-home OSA testing. Apnea-hypoapnea index (AHI) results recorded on returned diagnostic devices were evaluated by a sleep specialist. A telephone consultation with a program physician then provided each participant with an explanation of test results and referral into care. Based on AHI we identified individuals with moderate (AHI 16-30) to severe (AHI >30) OSA and referred them to care. Results Of the 89 participating individuals, 21% had 3 MetS components, 53% had 4 components, and 20% had 5 components; 30% were diabetic; 83% had hypertension; and >50% were obese. Moderate to severe OSA was diagnosed in 52 (58%) of participants. Of those, 50% had moderate OSA and 50%, had severe OSA. Among individuals with moderate to severe OSA, 29 (56%) had a physician consultation and were referred to treatment. Conclusion A personalized employer-sponsored healthcare outreach program identified individuals with unrecognized OSA and referred them into care. Support
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