ArticleMedical care2026
Concordance Between Self-Report and Electronic Medical Record Diagnoses of Insomnia and Sleep Apnea: Lessons From the Airborne Hazards and Open Burn Pit Registry.
Article in Medical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Health Care for Military Environmental Exposure Concerns.Medical care · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundVeteran participants in the Airborne Hazards and Open Burn Pit Registry (AHOBPR) report respiratory and sleep-related symptoms, including sleep-disordered breathing and difficulty sleeping. The AHOBPR Questionnaire elicits sleep-related disturbances and other health outcomes potentially associated with burn pit exposures. Responses to this questionnaire may influence resource allocation and future longitudinal studies of toxic sequelae. The level of agreement between sleep apnea and insomnia responses to the AHOPBPR questionnaire and clinical diagnoses of sleep apnea and insomnia in the electronic medical record (EMR) is unclear.
objectiveIn this study, we compare concordance between reports of symptoms associated with sleep apnea and insomnia to corresponding clinical diagnoses documented in EMRs among Veterans in the AHOBPR.
methodsWe included 469,179 Veterans with AHOBPR survey responses and available EMR data in the Veteran Health Administration. Concordances between reports of sleep-related symptoms on the AHOBPR questionnaire and relevant EMR diagnoses were analyzed for 469,179 Veterans. Concordance was assessed with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa coefficients. We further considered sex differences in concordance measures.
resultsReports of symptoms associated with sleep apnea were common (52% overall, 54.5% in men, 28.5% in women) as were EMR diagnoses (31.6% overall, 32.8% in men, 19.8% in women). The overall concordance between self-reported and EMR diagnoses for sleep apnea was fair (kappa=0.38). Reports of symptoms associated with insomnia were highly prevalent (81% overall, 80.8% in men, 82.6% in women) but poorly aligned with EMR diagnoses (17.8% overall, kappa=0.08). Agreement between reports of symptoms associated with sleep apnea and EMR-diagnosed sleep apnea was higher for females (kappa=0.46) than for males (kappa=0.37).
conclusionThis study highlights significant discrepancies between self-reported symptoms and EMR diagnoses of sleep apnea and insomnia among Veterans who completed the AHOBPR survey. While fair agreement for sleep apnea suggests some alignment with clinical diagnosis, poor concordance for insomnia highlights the limitations of self-reported case identification methods.
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