The Prevalence Rate and Risk of Obstructive Sleep Apnea in Canada

Abstract

PURPOSE: To report prevalence estimates of sleep apnea (SA), and its associated risk factors in the Canadian population. METHODS: The Public Health Agency of Canada developed and funded the 2009 Sleep Apnea Rapid Response Questionnaire to provide information on prevalence, risk, diagnosis, and treatment of SA among Canadians. The survey, conducted by Statistics Canada, sampled 8647 respondents ages 18 years and older. Prevalence rates for SA and high risk of obstructive sleep apnea (OSA) (defined by a modified STOP-BANG assessment tool) were estimated for individuals with various socio-demographic characteristics, risk behaviours, and chronic conditions. Adjusted prevalence rate ratios were estimated to assess characteristics associated with having SA and high risk of OSA. RESULTS: 3.4% of Canadian adults reported health professional diagnosed SA, while an additional 23.4% were at high risk for OSA. The prevalence of SA and high risk of OSA was significantly higher among males, individuals aged > 45 years, those who had a BMI of > 25 kg/m2, and individuals with other chronic conditions. Additional correlates significantly associated with high risk of OSA were ever being married/common-law, being a current smoker, and graduating from post secondary school (inverse). 4.8% of the total Canadian adult population and 76.8% of adults with SA reported being referred for sleep lab testing. The proportion of those at high risk of OSA (5.2%) who report sleep lab testing referral was not significantly different from the total population. 71% of adults with SA reported being prescribed treatment, while 61% reported both prescribed treatment and sleep lab testing referral. CONCLUSION: Over one quarter (26.8%) of Canadian adults have SA or are at high risk of OSA. Not all Canadian adults with SA were referred for sleep lab testing or were prescribed treatment, and adults at high risk of OSA were not any more likely to be referred for sleep lab testing than were adults in the total population. CLINICAL IMPLICATIONS: Greater attention is required to recognize the signs and symptoms consistent with sleep apnea.