OBJECTIVES: Obstructive Sleep Apnea (OSA) is a disease that leads to severe complications and adds significant morbidity if left untreated. Its prevalence in the general population is ranging between 4-40%. Accompanying OSA can impact treatment course, length-of-stay and outcomes in patients, requiring in-hospital treatment. Disease frequency in the general in-hospital population in Germany has not been determined so far. This study aims to assess the prevalence of OSA in German in-hospital patients, based on DRG claims data and determine disease frequency in specific subgroups with anticipated higher risk for OSA.

METHODS: Data on diagnosis of OSA was obtained from the official German Hospital Statistics, which routinely collects data for all in-hospital treatments. All treatments perfomed in the German in-patient system in 2015 were analyzed for primary or secondary diagnosis of OSA.

RESULTS: Total prevalence of OSA in the German in-patient system in 2015 was 1.80% (259.816 subjects of a total population of 14.426.814). Prevalence within different treatments varied significantly, ranging from 0.0-7.91%. Non-OSA related DRG with highest prevalence of OSA as comorbidity include treatments for COPD (3.30-6.89%), renal artery denervation (6.43%) and major bariatric surgery procedures (12.99%).

CONCLUSIONS: OSA can lead to complications and prolong treatment courses in non-OSA therapies. Epidemiogical studies estimate the prevalence of OSA between 4-40% of the general population. As such, the observed prevalence in this study appears low compared to the literature. The prevalence in specific subgroups with higher risk for OSA was as well lower than expected. Possible reasons for these findings include unawareness, under-diagnosis of OSA or under-coding of this specific condition in the required billing information. These observations suggest that the actual awareness of the disease is low among patients, physicians and paramedical staff involved in coding. Further research is required to better understand the underlying reasons for the low prevalance of OSA.