Obstructive sleep apnea syndrome in a publicly funded healthcare system

Despite its current recognition as a major health concern, little has been published about obstructive sleep apnea syndrome (OSAS) as a health problem in public healthcare systems where limited resources, language and cultural differences may present barriers to detection and treatment.

To describe patients referred for suspected OSAS in a large county-funded healthcare system.

A retrospective, descriptive observational study that included all patients referred for an OSAS evaluation between September 2000 and September 2002.

Only 123 patients were referred and 115 completed an evaluation during the two-year period: 99% met OSAS diagnostic criteria, which was severe in 79% and frequently complicated by related comorbid conditions. CPAP acceptance was lower than in the previous series, especially among Hispanics.

The findings suggest that referral for OSAS evaluation was limited to those most severely affected and raise the possibility of underdetection and undertreatment in the ublic sector.