Introduction Obstructive sleep apnea (OSA) impacts approximately 30% of 30–69-year-olds in Germany, however comprehensive real-world data on patient demographics, diagnostic pathway, and treatment patterns, remains limited. This study aims to analyze real-world data to characterize OSA patient profiles and their treatment journey within Germany. Methods Retrospective longitudinal analysis of German Statutory Health Insurance claims data, including 146,227 adults (≥18 years) diagnosed with OSA between 2012-2022. Data included patient demographics, clinical diagnoses, sleep study history, and treatments. Patients had a minimum six-month enrollment prior to OSA diagnosis or treatment. Results An analysis of 146,227 OSA-diagnosed patients reported a mean age of 58.6 years at the time of diagnosis, with males constituting 70.3% of this population. Although a majority had missing BMI data, among those recorded, approximately one-third had obesity category II-IV. Most common OSA-related comorbidities were hypertension, dyslipidemia, cardiovascular diseases, and type 2 diabetes. Majority underwent OSA diagnostic procedures like polygraphy (89.2%) and polysomnography (29.4%). Delving into treatment sequences for 84,246 patients, PAP emerged as the predominant initial therapy in 88% of patients. Alternatives like upper airway surgery (4.1%) and lifestyle modifications (0.8%) played a secondary role in the treatment landscape. Adherence patterns, evaluated among 74,605 patients on PAP therapy, showed that 95.7% were non-adherent within 12 months post-initiation. Lastly, intervals between sleep studies, diagnosis, and treatment commencement were analyzed for 80,931 patients. On average, there was a 23.3-month gap from the initial sleep study to OSA diagnosis. However, the subsequent gap from diagnosis to treatment was shorter, averaging 8.2 months, hinting at improved efficiency in care post-diagnosis. Conclusion These results reveal a substantial burden of OSA , particularly in older males with metabolic comorbidities. While PAP therapy is the predominant initial treatment modality, its effectiveness is undermined by a high non-adherence rate within the first year of treatment. This high rate of non-adherence coupled with the lengthy diagnostic delays underscores critical unmet need in the current OSA treatment paradigm. Support (if any)
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Shinde et al. (2024) studied this question.
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