Age- and sex-stratified prevalence of obstructive sleep apnea and stroke risk comorbidities: A large cross-sectional EHR study
4 affiliations
- 1Department of Health Informatics, College of Informatics, Northern Kentucky University, Highland Heights, Kentucky, United States of America
- 2Department of Management Science and Information Systems, Center for Health Systems Innovation, Spears School of Business, Oklahoma State University, Stillwater, Oklahoma, United States of America
- 3Department of Management Information Systems, Faculty of Business Administration, Haliç University, Istanbul, Türkiye
- 4Center for Health Sciences, Oklahoma State University, Tulsa, Oklahoma, United States of America
Abstract
Objective: To characterize age- and sex-stratified prevalence patterns of obstructive sleep apnea and co-morbid conditions corresponding to CHA2DS2−VASc components using a large, population-based electronic health record dataset. Study Design: The study cohort included 556,474 unique de-identified OSA patients (ICD-9 code 327.23), mined from HIPAA-compliant Cerner HealthFacts® database (1999–2016). The patient records were mined using Structured Query Language (SQL), stratified by age, gender, and stroke risk comorbidities per CHA2DS2−VASc, to conduct a population-based cross-sectional epidemiological study. Methods: Clinical and epidemiological research informatics methodologies are applied to characterize OSA prevalence patterns across age (5-year intervals), gender, and stroke risk comorbidities per CHA2DS2−VASc criteria. Body-level organ system involvement was examined according to the Major Diagnostic Category (MDC) classification. Results: Age-stratified cross-sectional analyses showed that prevalence rates for OSA (m: 10.43%, f: 9.28%), hypertension (m: 7.37%, f: 7.11%), along with clinical encounters, peaked at age 55 for both genders, whereas the highest prevalence of cardiovascular comorbidities was observed in older age groups (ages 65–70). Hypertension was most prevalent (57.83%), followed by diabetes (34.7%), congestive heart failure (17.7%), atrial fibrillation (13.31%), vascular disease (12.3%), and prior stroke/TIA (4.78%). Conclusion: This large cross-sectional study (556,474 patients) provides detailed age- and sex-specific prevalence estimates of OSA-associated stroke-risk comorbidities. While causal or temporal inferences cannot be drawn, the findings highlight population-level prevalence patterns that may inform hypothesis-driven longitudinal studies and future evaluation of stroke-risk models.
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BibTeX
@article{agrawal2026sexstratified,
title = {{Age- and sex-stratified prevalence of obstructive sleep apnea and stroke risk comorbidities: A large cross-sectional EHR study}},
author = {Rupesh Agrawal and Dursun Delen and Bruce Benjamin and Rani Misra},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0357824},
url = {https://doi.org/10.1371/journal.pone.0357824},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Age- and sex-stratified prevalence of obstructive sleep apnea and stroke risk comorbidities: A large cross-sectional EHR study
AU - Rupesh Agrawal
AU - Dursun Delen
AU - Bruce Benjamin
AU - Rani Misra
PY - 2026
DA - 2026/09/30
JO - PLOS One
DO - 10.1371/journal.pone.0357824
UR - https://doi.org/10.1371/journal.pone.0357824
AB - Objective: To characterize age- and sex-stratified prevalence patterns of obstructive sleep apnea and co-morbid conditions corresponding to CHA2DS2−VASc components using a large, population-based electronic health record dataset. Study Design: The study cohort included 556,474 unique de-identified OSA patients (ICD-9 code 327.23), mined from HIPAA-compliant Cerner HealthFacts® database (1999–2016). The patient records were mined using Structured Query Language (SQL), stratified by age, gender, and stroke risk comorbidities per CHA2DS2−VASc, to conduct a population-based cross-sectional epidemiological study. Methods: Clinical and epidemiological research informatics methodologies are applied to characterize OSA prevalence patterns across age (5-year intervals), gender, and stroke risk comorbidities per CHA2DS2−VASc criteria. Body-level organ system involvement was examined according to the Major Diagnostic Category (MDC) classification. Results: Age-stratified cross-sectional analyses showed that prevalence rates for OSA (m: 10.43%, f: 9.28%), hypertension (m: 7.37%, f: 7.11%), along with clinical encounters, peaked at age 55 for both genders, whereas the highest prevalence of cardiovascular comorbidities was observed in older age groups (ages 65–70). Hypertension was most prevalent (57.83%), followed by diabetes (34.7%), congestive heart failure (17.7%), atrial fibrillation (13.31%), vascular disease (12.3%), and prior stroke/TIA (4.78%). Conclusion: This large cross-sectional study (556,474 patients) provides detailed age- and sex-specific prevalence estimates of OSA-associated stroke-risk comorbidities. While causal or temporal inferences cannot be drawn, the findings highlight population-level prevalence patterns that may inform hypothesis-driven longitudinal studies and future evaluation of stroke-risk models.
SN - 1932-6203
ER -