OBJECTIVES: Sleep Apnea (SA) is an increasingly common, chronic, sleep-related breathing disorder which, if untreated, can lead to potentially serious health complications. This study aimed to assess the clinical profile and healthcare pathway for patients with SA in Italy through use of a primary care database of Italian general practitioners (GPs).

METHODS: A real-world evidence, retrospective, cohort study using the IQVIA Italian longitudinal patient database was conducted to investigate the clinical and healthcare profiles of SA patients. Eligible patients fulfilled the following criteria: diagnosis of Unspecified SA (ICD9: 780.57), Insomnia with SA (ICD9: 780.51), or Hypersomnia with SA (ICD9: 780.53) between January 2017 and December 2018 (selection period); aged ≥18 years; one-year follow-up. Index date was the date patients received their first SA diagnosis in the selection period. Population was stratified into those newly diagnosed (no SA diagnosis ≥1-year before index date) and those with an existing diagnosis.

RESULTS: 9412 SA patients were identified, of whom 7988 (85%) were newly diagnosed. Males represented 70% of both the overall SA group and the newly diagnosed group. Most patients in both the overall (6196;66%) and newly diagnosed (5240;66%) groups were aged 40-69 years. >50% of SA patients were hypertensive: 5051 (54%) overall and 4151 (52%) newly diagnosed. In the patient pathway for newly diagnosed patients, GPs most frequently requested a polysomnography (1516;19%) or a pulmonologist visit (1781;22%) as the first assessment of diagnosis. Following diagnosis, GPs directed SA patients into the most appropriate onward care pathway, with pulmonologists being the most common referral (overall: 2662;44%; newly diagnosed: 2396;50%) followed by polysomnography, usually a prelude to subsequent specialist examination (overall: 2833;30%; newly diagnosed: 2498;32%).

CONCLUSIONS: This study provides additional details on the clinical profile of SA patients in Italy and highlights the key role of GPs in recommending the appropriate onward care pathway.