A comparison of public and private obstructive sleep apnea clinics

ABSTRACT

The aim of the present study was to compare the clinical findings and polysomnography results obtained at public and private clinics in Brazil, the follow-up after diagnosis, and the therapeutic aspects related to continuous positive airway pressure. Patients who snore and who have obstructive sleep apnea were retrospectively divided into two groups, i.e., public clinic (N = 307) and private clinic (N = 317). Data concerning age, sex, body mass index (BMI), neck circumference, medical history, sleepiness scale, follow-up after diagnosis, and acceptance of continuous positive airway pressure therapy were collected. Mean age was 50 ± 12 (range 15-80) for public patients and 48 ± 12 years (range 19-91) for private patients. Mean BMI was 30 ± 6 (range 19-67) for public patients and 31 ± 6 kg/m² (range 21-59) for private patients. The public clinic had a significantly higher frequency of women than the private clinic (MF ratio of 2.01 and 6.91, respectively). The condition of private patients (apnea-hypopnea index = 31 ± 25) was more severe than that of public patients (apnea-hypopnea index = 25 ± 24 events/h; P = 0.0004). In the public and private clinics, 19 and 15 percent of patients were snorers, respectively, and 81 and 85 percent of them had sleep apnea. After diagnosis, follow-up was longer in the private group. The continuous positive airway pressure acceptance was similar for both groups (32 vs 35 percent), but patients from the public clinic abandoned treatment more than private ones (65 vs 13 percent). Social status was significant in terms of the severity of obstructive sleep apnea age and gender distribution. Private patients look for a diagnosis earlier in the course of the disease than public patients, adhere more to follow-up, and abandon continuous positive airway pressure treatment less than public patients do.