High obstructive sleep apnea severity and lack of treatment access in MassHealth Limited patients, a predominantly Latinx population

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-06-20 DOI:10.1016/j.sleep.2025.106648

Christopher A. Cano , Sogol Javaheri

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引用次数: 0

Abstract

Objectives

MassHealth Limited (MHL), a subset of Massachusetts’ Medicaid program, covers sleep studies but not obstructive sleep apnea (OSA) treatment, including positive airway pressure (PAP) therapy. This study characterizes the demographics and OSA severity of patients receiving MHL and compares them to those with full MassHealth (MH) benefits to assess inequities in treatment access.

Participants and methods

We conducted a retrospective cohort study of 134 MHL and 402 MH patients who underwent a sleep study for OSA evaluation at the Brigham and Women’s Faulkner Hospital (2019–2024). We analyzed age, BMI, OSA severity, SpO₂ % nadir, and comorbidity burden across four patient groups based on insurance and self-reported ethnicity: MHL-Latinx, MH-Latinx, MH-Black, and MH-White, with men and women assessed separately.

Results

The MHL population was predominantly Latinx (90 %), with 82 % preferring Spanish, Haitian Creole, or Brazilian Portuguese as their primary language. Moderate-to-severe OSA was most prevalent in MHL-Latinx men (77.5 %) and MHL-Latinx women (53.0 %). On follow-up, about one-third of MHL-Latinx patients with moderate-to-severe OSA obtained PAP therapy through self-pay or insurance change.

Conclusions

In this sample of MHL beneficiaries, a predominantly Latinx population, patients experience a high burden of moderate-to-severe OSA yet lack access to PAP therapy due to insurance limitations. Expanding MHL coverage to include OSA treatment is critical to addressing sleep health inequities.

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高阻塞性睡眠呼吸暂停严重程度和缺乏治疗的mashealth有限患者，主要是拉丁裔人群

麻省健康有限公司（MHL）是马萨诸塞州医疗补助计划的一个子集，涵盖睡眠研究，但不包括阻塞性睡眠呼吸暂停（OSA）治疗，包括气道正压（PAP）治疗。本研究描述了MHL患者的人口统计学特征和OSA严重程度，并将其与完全享受MassHealth （MH）福利的患者进行比较，以评估治疗可及性方面的不公平。参与者和方法我们对布莱根妇女福克纳医院（Brigham and Women’s Faulkner Hospital）的134名MHL和402名MH患者进行了回顾性队列研究，这些患者接受了睡眠研究以进行OSA评估（2019-2024）。我们根据保险和自我报告的种族分析了四组患者的年龄、BMI、OSA严重程度、SpO2最低点和合并症负担：mhl -拉丁裔、mh -拉丁裔、mh -黑人和mh -白人，男性和女性分别评估。结果MHL人群主要是拉丁裔（90%），82%的人喜欢西班牙语、海地克里奥尔语或巴西葡萄牙语作为他们的主要语言。中度至重度OSA在mhl -拉丁裔男性（77.5%）和mhl -拉丁裔女性（53.0%）中最为普遍。在随访中，约三分之一的MHL-Latinx中重度OSA患者通过自费或保险变更获得PAP治疗。结论：在MHL受益人样本中，主要是拉丁裔人群，患者经历了中重度OSA的高负担，但由于保险限制，缺乏PAP治疗。扩大MHL的覆盖范围，使其包括阻塞性睡眠呼吸暂停治疗，对于解决睡眠健康不平等问题至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.