Geriatric Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California.
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California.
J Clin Sleep Med. 2021 Mar 1;17(3):555-565. doi: 10.5664/jcsm.8956.
The goals of this study were to estimate rates of undiagnosed, diagnosed, and treated sleep apnea in women veterans and to identify factors associated with diagnosis and treatment of sleep apnea in this population.
A large nationwide postal survey was sent to a random sample of 4,000 women veterans who had received health care at a Veterans Health Administration (VA) facility in the previous 6 months. A total of 1,498 surveys were completed. Survey items used for the current analyses included: demographics; sleep apnea risk, diagnostic status, and treatment; symptoms of other sleep disorders (eg, insomnia); mental health symptoms; and comorbidities.
Among responders, 13% of women reported a prior sleep apnea diagnosis. Among women who reported a diagnosis of sleep apnea, 65% reported using positive airway pressure therapy. A sleep apnea diagnosis was associated with older age, higher BMI, non-Hispanic African American/Black racial/ethnic identity, being unemployed, other sleep disorder symptoms (eg, insomnia), depression and post-traumatic stress disorder symptoms, and multimorbidity. Among women without a sleep apnea diagnosis, 43% scored as "high risk" on the STOP (snoring, tiredness, observed apneas, blood pressure) questionnaire. High risk scores were associated with older age, higher BMI, African American/Black identity, other sleep disorder symptoms (eg, insomnia), mental health symptoms, and multimorbidity. Only BMI differed between women using vs not using positive airway pressure therapy.
Women veterans with diagnosed sleep apnea were commonly treated with positive airway pressure therapy, which is standard first-line treatment; however, many undiagnosed women were at high risk. Efforts to increase screening, diagnosis, and treatment of sleep apnea in women with comorbid mental and physical health conditions are needed.
本研究旨在评估女性退伍军人中未确诊、已确诊和已治疗的睡眠呼吸暂停的发生率，并确定该人群中与睡眠呼吸暂停诊断和治疗相关的因素。
一项大型全国性邮政调查被发送给了在过去 6 个月内曾在退伍军人健康管理局（VA）医疗机构接受过医疗保健的 4000 名女性退伍军人的随机样本。共完成了 1498 份调查。当前分析中使用的调查项目包括：人口统计学；睡眠呼吸暂停风险、诊断状况和治疗；其他睡眠障碍（如失眠）的症状；心理健康症状；和合并症。
在应答者中，13%的女性报告了先前的睡眠呼吸暂停诊断。在报告有睡眠呼吸暂停诊断的女性中，65%报告使用了正压通气治疗。睡眠呼吸暂停的诊断与年龄较大、BMI 较高、非西班牙裔非裔/黑人种族/民族身份、失业、其他睡眠障碍症状（如失眠）、抑郁和创伤后应激障碍症状以及合并症有关。在没有睡眠呼吸暂停诊断的女性中，43%在 STOP（打鼾、疲劳、观察到的呼吸暂停、血压）问卷上的评分“高风险”。高风险评分与年龄较大、BMI 较高、非裔/黑人身份、其他睡眠障碍症状（如失眠）、心理健康症状和合并症有关。只有 BMI 在使用与不使用正压通气治疗的女性之间存在差异。
患有确诊睡眠呼吸暂停的女性退伍军人通常使用正压通气治疗，这是标准的一线治疗方法；然而，许多未确诊的女性处于高风险之中。需要努力增加对患有合并精神和身体健康状况的女性的睡眠呼吸暂停筛查、诊断和治疗。
