title: The medical cost of undiagnosed sleep apnea.
abstract: Obstructive sleep apnea is an under-diagnosed, but common disorder with serious adverse consequences. Cost data from the year prior to the diagnosis of sleep-disordered breathing in a consecutive series of 238 cases were used to estimate the potential medical cost of undiagnosed sleep apnea and to determine the relationship between the severity of sleep-disordered breathing and the magnitude of medical costs. Among cases, mean annual medical cost prior to diagnosis was $2720 versus $1384 for age and gender matched controls (p<0.01). Regression analysis showed that the reciprocal of the apnea hypopnea index among cases was significantly related to log-transformed annual medical costs after adjusting for age, gender, and body mass index (p<0.05). We conclude that patients with undiagnosed sleep apnea had considerably higher medical costs than age and sex matched individuals and that the severity of sleep-disordered breathing was associated with the magnitude of medical costs. Using available data on the prevalence of undiagnosed moderate to severe sleep apnea in middle-aged adults, we estimate that untreated sleep apnea may cause $3.4 billion in additional medical costs in the U.S. Whether medical cost savings occur with treatment of sleep apnea remains to be determined.
authors.affiliation: Department of Medicine, University of Washington, Seattle 98195, USA.
authors.forename: V
authors.initials: V
authors.lastname: Kapur
authors.forename: D K
authors.initials: DK
authors.lastname: Blough
authors.forename: R E
authors.initials: RE
authors.lastname: Sandblom
authors.forename: R
authors.initials: R
authors.lastname: Hert
authors.forename: J B
authors.initials: JB
authors.lastname: de Maine
authors.forename: S D
authors.initials: SD
authors.lastname: Sullivan
authors.forename: B M
authors.initials: BM
authors.lastname: Psaty
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors / Q000191:economics; D005260:Female; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000191:economics*