LAUSR

RATIONALE Obstructive sleep apnea (OSA) is a common treatable condition with important health and societal consequences. OBJECTIVES We aimed to assess annual incidence and prevalence of clinically recognized and geographic clustering of OSA in Alberta, Canada using administrative health data case definitions. METHODS We used two administrative health databases in Alberta to identify ICD-9 and ICD-10 diagnostic codes for adults and children ≥ two years old diagnosed with OSA from 2003-2020. We defined OSA using an algorithm that was developed and validated in Alberta: at least three claims or one hospitalization within two years. We mapped residential postal code to 70 sub-regional health authorities (SRHAs). Crude, age group- and sex-specific incidence and prevalence, and age group- and sex-standardized rates were calculated for Alberta and for SRHAs. Spatial scan statistics identified clusters of SRHAs in which OSA cases were higher ("hot spots") or lower ("cold spots") than expected. RESULTS Between 2003 and 2020, OSA prevalence increased from 0.14% to 4.59%. Annual incidence of OSA increased after 2013. Incidence and prevalence were higher in older adults, and higher in children aged 2-11 compared to 12-17 years. Cluster analysis revealed regional variation in OSA incidence and prevalence over time with no consistent pattern except for cold spots in one large metropolitan centre (Calgary). CONCLUSION From 2003-2020 the incidence and prevalence of clinically recognized OSA increased but varied by geography. Administrative health data can be used to guide interventions aimed at improving health service delivery and quality of OSA care.