In Reply Dr Fleishman states that in the United States, there is little role for primary care in the management of OSA because an extensive system of sleep centers is sufficiently meeting this need. We are not aware of any data to verify his assertions. The rapid increase in obesity is likely to have substantially increased the burden of OSA in the United States because the prevalence of moderate to severe OSA is now almost 20% elsewhere.1,2 It is unrealistic to expect sleep physicians alone to address this substantial burden of disease.
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