Recently completed a study of barriers/facilitators to OSA care in the safety-net for AHRQ. Nine Community Health Clinics (CHCs) participated, findings suggest that PCPs infrequently screen or diagnose OSA. Traditional sleep studies are essentially unavailable for the uninsured due to long wait times for a County appointment. OSA evaluation is also often overshadowed by other more urgent health conditions. Providers recall seeing an average of 3 to 5 patients a year in which they suspect OSA. Of these, 0 to 1 receive an ICD-9 code and are contained in the billings records.
Treatment options are similarly limited. Uninsured patients have difficulty accessing CPAP and patient compliance is an issue once obtained. Most frequently prescribed treatments are weight loss, allergy medications, and adjustment of sleep position. Success of these alternative treatments are low.
A new pilot project is underway with the University of Southern California to test a new device for the treatment of OSA.