Mapping Regional Use of Home Sleep Apnea Testing in Brazil

Keywords

OSA - healthcare access - HSAT - sleep diagnosis

Introduction: Obstructive Sleep Apnea (OSA) is a prevalent condition that remains underdiagnosed and untreated, mainly in Latin America, leading to significant health and economic burdens. Major disparities in access to OSA diagnosis and treatment in Brazil were recently published and revealed that in-lab polysomnography (PSG) is the most common diagnostic method within Brazil's public health system, potentially causing delays in diagnose and treatment. Home Sleep Apnea Testing (HSAT) is a viable alternative for diagnosing OSA in uncomplicated adults, potentially addressing the large number of undiagnosed cases in Brazil.

Objective: To evaluate the growth of type III HSAT utilization in Brazil, identify potential regional disparities, and describe the proportion of patients diagnosed with OSA.

Methods: Anonymized data from all diagnostic centers utilizing a type III HSAT (ApneaLink Air) connected to a diagnostic cloud solution (AirView) were analyzed from January 2018 to June 2024. Descriptive analyses were conducted to assess the overall number of tests, growth over time, and regional distribution across Brazil. The proportion of positive diagnoses at apnea-hypopnea (AHI) thresholds of ≥5, ≥15, and ≥30 events/hour were also examined.

Results: A total of 154,407 HSATs using the ApneaLink Air were conducted across Brazil from 2018 to 2024, with an average growth of 103% in the number of HSATs performed and a total increase of 2,502% over this period. The Southeast region conducted the majority of the tests, accounting for 67.6% (104,348) of the total, followed by the South (18.8%,29,012), Northeast (10.1%,15,590), Central-West (2.9%,4,479), and North (0.7%,1,078). Among the tested patients, 74.4% (114,912) were identified with mild sleep apnea (AHI ≥ 5 events/hour), 43.4% with moderate to severe (AHI ≥15), and 20.6% with severe (AHI ≥30) OSA.

Conclusion: The significant increase in HSAT(ApneaLink) utilization for diagnosing OSA from 2018 to June 2024 highlights significant progress in expanding access to OSA diagnosis in Brazil. However, the data reveals persistent regional disparities, with the Southeast region overwhelmingly leading in diagnostic activity, while the North and Central-West regions remain significantly underrepresented. These findings underscore the need for targeted efforts to expand diagnostic infrastructure, professional training, and community education in underserved areas, ensuring that all patients nationwide have access to diagnostic and treatment.

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Publikationsverlauf

Artikel online veröffentlicht:
16. September 2025