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dc.contributor.authorRobbins, Rebecca
dc.contributor.authorSeixas, Azizi
dc.contributor.authorJean-Louis, Girardin
dc.contributor.authorParthasarathy, Sairam
dc.contributor.authorRapoport, David M.
dc.contributor.authorOgedegbe, Gbenga
dc.contributor.authorLadapo, Joseph A.
dc.date.accessioned2018-08-15T23:40:10Z
dc.date.available2018-08-15T23:40:10Z
dc.date.issued2018-05-23
dc.identifier.citationRobbins R, Seixas A, Jean-Louis G, Parthasarathy S, Rapoport DM, Ogedegbe G, et al. (2018) National patterns of physician management of sleep apnea and treatment among patients with hypertension. PLoS ONE 13(5): e0196981. https://doi.org/10.1371/journal.pone.0196981en_US
dc.identifier.issn1932-6203
dc.identifier.pmid29791455
dc.identifier.doi10.1371/journal.pone.0196981
dc.identifier.urihttp://hdl.handle.net/10150/628546
dc.description.abstractStudy objectives Sleep apnea is associated with hypertension, and treatment may improve outcomes. We examine national burden of sleep apnea, rates of sleep apnea treatment, and whether racial/ethnic disparities exist among patients with hypertension. Methods Data from the National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey (NAMCS/NHAMCS), 2005-2012, were analyzed (N = 417,950). We identified hypertension patient visits where sleep apnea diagnosis or complaint was recorded. Primary outcome measures were sleep study, medication, or behavioral therapy (diet, weight loss, or exercise counseling). We used multivariate logistic regression to examine treatment by demographic/clinical factors. Results Among patients with hypertension, sleep apnea was identified in 11.2-per-1,000 visits. Overall, patients with hypertension and a sleep disorder were referred for sleep study in 14.4% of visits, prescribed sleep medication in 11.2% of visits, and offered behavioral therapy in 34.8% of visits. Adjusted analyses show behavioral therapy more likely to be provided to obese patients than normal/overweight (OR = 4.96, 95%CI[2.93-8.38]), but less likely to be provided to smokers than nonsmokers (OR = 0.54, 95%)/CI[0.32-0.93]). Non-Hispanic blacks were less likely to receive medications than non-Hispanic whites (OR = 0.19, 95% CI[0.06-0.65]). Conclusions In the U.S., sleep apnea were observed in a small proportion of hypertension visits, a population at high-risk for the disorder. One explanation for the low prevalence of sleep apnea observed in this patient population at high risk for the disorder is under-diagnosis of sleep related breathing disorders. Behavioral therapy was underutilized, and non-Hispanic Blacks were less likely to receive medications than non-Hispanic Whites.en_US
dc.description.sponsorshipNational Heart, Lung, and Blood Institute [R25HL116378, K23 HL116787]; National Institutes of Health [R01 MD011544]; Robert Wood Johnson Foundation [72426]en_US
dc.language.isoenen_US
dc.publisherPUBLIC LIBRARY SCIENCEen_US
dc.relation.urlhttp://dx.plos.org/10.1371/journal.pone.0196981en_US
dc.relation.urlhttp://dx.plos.org/10.1371/journal.pone.0196981.t001en_US
dc.relation.urlhttp://dx.plos.org/10.1371/journal.pone.0196981.t002en_US
dc.relation.urlhttp://dx.plos.org/10.1371/journal.pone.0196981.t003en_US
dc.rights© 2018 Robbins et al. This is an open access article distributed under the terms of the Creative Commons Attribution License.en_US
dc.titleNational patterns of physician management of sleep apnea and treatment among patients with hypertensionen_US
dc.typeArticleen_US
dc.contributor.departmentUniv Arizona, Dept Meden_US
dc.identifier.journalPLOS ONEen_US
dc.description.noteOpen access journal.en_US
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en_US
dc.eprint.versionFinal published versionen_US
dc.source.journaltitlePLOS ONE
dc.source.volume13
dc.source.issue5
dc.source.beginpagee0196981
refterms.dateFOA2018-08-15T23:40:10Z


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