Can Respir J. 2014 Jan-Feb;21(1):e4-10. doi: 10.1155/2014/592947. Epub 2013 Nov 28.
An estimated 5.4 million Canadian adults have been diagnosed with sleep apnea or are at high risk of experiencing obstructive sleep apnea (OSA). There are no recent Canadian data regarding access to and predictors of referral for diagnostic testing in these populations.
The Sleep Apnea Rapid Response survey sampled 8647 Canadian adults and captured information about risk, testing, diagnosis and treatment of sleep apnea. Predictors of sleep laboratory test referrals were assessed using log-linked binomial regression modelling. Information regarding sleep testing facilities was updated at the provincial and regional levels.
Approximately 76.8% (95% CI 70.1% to 83.6%) of adult Canadians with sleep apnea and 5.1% (95% CI 3.4% to 6.7%) of those at high risk for OSA reported being referred to a sleep laboratory. Significant predictors of sleep laboratory referral in the general population were male sex, middle age, overweight or obese, a chronic condition, having a regular medical doctor and reporting symptoms of sleep apnea. Region of residence was also a predictor of reported sleep laboratory referral, with individuals from Ontario being more likely to report being referred to a sleep laboratory versus individuals from other regions.
Individuals reporting risk factors and symptoms associated with OSA were more likely to report a sleep laboratory testing referral compared with those without risk factors or symptoms. However, Canada's diagnostic sleep laboratory testing capacity varies across regions and is believed to be inadequate given the number of individuals at high risk for OSA who did not report testing referral.
据估计，有 540 万加拿大成年人被诊断患有睡眠呼吸暂停或有发生阻塞性睡眠呼吸暂停（OSA）的高风险。目前尚无关于这些人群获得诊断性检测机会和转诊预测因素的加拿大近期数据。
睡眠呼吸暂停快速反应调查对 8647 名加拿大成年人进行了抽样调查，收集了有关睡眠呼吸暂停风险、检测、诊断和治疗的信息。使用对数链接二项式回归模型评估了睡眠实验室测试转诊的预测因素。在省级和地区级更新了有关睡眠测试设施的信息。
约 76.8%（95%CI70.1%至 83.6%）的加拿大成年睡眠呼吸暂停患者和 5.1%（95%CI3.4%至 6.7%）的 OSA 高危人群报告被转诊至睡眠实验室。一般人群中睡眠实验室转诊的显著预测因素为男性、中年、超重或肥胖、慢性病、有常规医生就诊和报告睡眠呼吸暂停症状。居住地也是报告睡眠实验室转诊的预测因素，安大略省的个体比其他地区的个体更有可能报告被转诊至睡眠实验室。
与无风险因素或症状的个体相比，报告与 OSA 相关的风险因素和症状的个体更有可能报告睡眠实验室检测转诊。然而，加拿大的诊断性睡眠实验室检测能力在各地区存在差异，考虑到有相当数量的 OSA 高危人群未报告接受检测转诊，因此这种检测能力被认为是不足够的。
