• Benjamin Arsic, Kristina Zebic, Aamna Sajid, Neha Bhave, Karla D Passalacqua, Denise White-Perkins, Lois Lamerato, Della Rees, and Katarzyna Budzynska.
• From the Department of Family Medicine, Henry Ford Hospital, Detroit, MI (BA, KZ, NB, DW-P, and KB);Department of Medical Education, Henry Ford Hospital, Detroit, MI (KDP); Department of Public Health Sciences, Henry Ford Health System, Detroit, MI (LL and DR); and Wayne State University, Detroit, MI (AS).
• J Am Board Fam Med. 2022 Mar 1; 35 (2): 320-328.

IntroductionThe exact prevalence of obstructive sleep apnea (OSA) is unknown, and primary care providers are left with conflicting guidance on screening criteria from various institutions. The purpose of this study was to identify health care gaps in OSA diagnosis for patients at high risk of OSA.MethodsA retrospective medical record review was performed assessing adult patients (≥ 18 years) who had outpatient visits in family medicine clinics, located in the cities of Detroit, Troy, and Commerce, Michigan in 2018. The primary outcome was the number of patients assessed for OSA. Patients determined as high risk for OSA had at least 3 of the following criteria: (1) hypertension, (2) age 50 years and older, (3) male gender, and (4) body mass index > 35 kg/m2. Statistical approach included univariate and logistic regression analysis. Manual chart review of 200 randomly selected records was performed to determine the most common reasons for OSA screening.ResultsOut of 30,022 patients, 4,911 (16.4%) were at high risk for OSA, of which 1,524 (31.0%) were assessed for OSA. Logistic regression analysis of high-risk patients revealed that male sex (odds ratio, 1.84; 95% CI, 1.51-2.26; P < .001) and body mass index > 35 kg/m2 (odds ratio, 4.96; 95% CI, 4.04-6.09; P < .001) were significantly associated with OSA evaluation. Race was not associated with OSA assessment.ConclusionBecause many individuals at high risk for OSA are not referred for evaluation, improved guidance on OSA screening based on objective risk factors is needed.© Copyright 2022 by the American Board of Family Medicine.

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