Study finds one-third of American and European primary care patients at high risk for sleep apnea

Researchers reported at the American Thoracic Society 2001 International Conference that about one-third of primary care patients in the United States and Europe have risk factors for sleep apnea, a disorder in which a person stops breathing during sleep. The study, presented May 23, is the first direct comparison of primary care populations among countries in regard to these risk factors, such as persistent snoring and daytime sleepiness.

Specifically, 36 percent of U.S. patients and 26 percent of European patients report risk factors for sleep apnea. Overall, U.S. patients have greater daytime sleepiness and obesity, as well as a composite score for high risk for sleep apnea, despite similar rates with Europeans for chronic snoring. About 31 percent of those surveyed say they experience excessive daytime sleepiness, with a higher prevalence in the United States (34.6 percent versus 10.1 percent in Europe).

The study finds variations among genders. Men have greater overall risk than women, independent of where they live. However, U.S. women have a higher risk of sleep apnea than their European counterparts, while U.S. and European men have a more similar risk. Aging results in less difference among genders and a higher European rate of persistent snoring, but overall risk still remains higher in the United States.

Reports of sleepiness while driving an automobile are more common in U.S. patients. Eighteen percent of Americans report they drive while sleepy at least three to four times a week, while 8 percent of Europeans report driving while sleepy.

The researchers say these findings indicate a need for more resources for recognition and management of sleepiness and sleep apnea on both continents. "Sleepiness, fatigue, and inattention are major causes not only of car crashes, but also of personal accidents and workplace errors," says Kingman Strohl, an author on the study and a professor of medicine at Case Western Reserve University's School of Medicine and the Louis Stokes Cleveland Veterans Affairs Medical Center. "Reductions in sleepiness can reduce these adverse events, but also increase the sense of wellness," he says.

The findings are based on 6,245 questionnaires completed by patients who were 15 years of age and older at 34 primary care sites in the United States, Spain, and Germany.