Sleep apnea in a high risk population: a study of Veterans Health Administration beneficiaries

In the present study we attempt to determine the prevalence of International Classification of Disease-ninth revision, Clinical Modification (ICD-9 CM) coded sleep apnea with cardiovascular and metabolic co-morbidities in Veterans Health Administration (VHA) beneficiaries.

Using VHA administrative databases, we gathered available medical information on more than 4 million veterans using the VHA during the period between 1998 and 2001. We identified database entries for codes indicating sleep apnea using the ninth revision of the Clinical Modification of the International Classification of Diseases (ICD-9 CM); and tabulated demographic data including age, gender, ethnicity, and cardiovascular and metabolic co-morbidities.

We found 118,105 unique cases (out of 4,060,504) with sleep apnea ICD-9 CM codes (prevalence of 2.91%). Mean age at diagnosis was 57.6 with more than 38% older than 65 years. Comorbid diagnoses in this group included hypertension (60.1%), obesity (30.5%), diabetes mellitus (32.9%), cardiovascular disease (including MI and angina) (27.6%), heart failure (13.5%), and cerebrovascular accident (including Transient Ischemic Attack (TIA)) (5.7%).

We found a high prevalence of diagnosed sleep apnea among VHA beneficiaries. Additionally, cardiovascular and metabolic conditions were common in these patients.