Documentation of sleep apnea in nursing homes: United States 2004

Objectives: To define the prevalence of documented sleep apnea in US nursing home (NH) residents and to examine characteristics associated with sleep apnea in this population. Design: Cross-sectional survey conducted in 2004. Setting: US nursing homes. Participants: Participants were 13,507 NH residents representing approximately 1.49 million individuals nationwide. Measurements: Up to 16 diagnoses were abstracted from the medical record at the time of the survey. Residents with any of 10 ICD-9 codes for sleep apnea were identified. Results: Sleep apnea was documented in 0.5% (95% CI: 0.4% to 0.6%) of US NH residents. The majority of these cases were coded as 780.57, unspecified sleep apnea. The unexpectedly small number of NH residents with documented sleep apnea precluded analyses of correlates of this condition in US NH residents. Conclusions: In 2004, sleep apnea was virtually undocumented among US NH residents. The near absence of recorded apnea may be due to selective mortality associated with sleep apnea, a perception on the part of physicians that apnea is a low priority or low impact condition in the context of the multiplicity of comorbidities in this patient population, or a combination of these and other factors.