Utilization of healthcare resources in obstructive sleep apnea syndrome: a 5-year follow-up study in men using CPAP.
OBJECTIVE
Patients with untreated obstructive sleep apnea syndrome (OSAS) have higher healthcare utilization than matched controls. However, the long-term impact of continuous positive airway pressure (CPAP) use on healthcare utilization is unknown.


METHODS
Retrospective observational cohort study.


METHODS
There were 342 eligible men with OSAS and matched controls on whom there were utilization data for 5 years prior to initial OSAS diagnosis and for the 5 years on CPAP treatment of the cases.


METHODS
Patients were treated with CPAP.


RESULTS
Patients with OSAS were typical cases (mean +/- SD): age, 48.2 +/- 0.6 years; body mass index, 35.6 +/- 0.4 kg/m2; Epworth Sleepiness Scale score, 14.2 +/- 0.3; apnea-hypopnea index, 47.1 +/- 1.8 events per hour. The number of physician visits were higher by 3.46 +/- 0.2 (95% confidence interval [CI]: 2.57 to 4.36) in cases in the year before diagnosis, compared with the fifth year before diagnosis, then decreased over the next 5 years by 1.03 +/- 0.49 (95% CI: -1.99 to -0.07)(P<.0001). Physician fees, in Canadian dollars, were higher by dollars 148.65 +/- dollars 27.27 (95% CI: 95.12 to 202.10) in cases in the year before diagnosis, compared with the fifth year before diagnosis, and then decreased over the next 5 years by dollars 13.92 +/- dollars 27.94(95%CI: -68.68 to 40.83)(P=.0009). Preexisting ischemic heart disease at the time of OSAS diagnosis predicted about a 5-fold increase in healthcare utilization between the second and fifth year of treatment.


CONCLUSIONS
Treatment of OSAS reversed the trend of increasing healthcare utilization seen prior to diagnosis. Preexisting ischemic heart disease results in a negative impact on healthcare utilization. CPAP results in a long-term health benefit, as measured by the use of healthcare services.
Albarrak
Mohammed
M
Sleep Disorders Center, St Boniface General Hospital, Section of Respiratory Diseases, Winnipeg, Manitoba, Canada.
Banno
Katsuhisa
K
Sabbagh
Ahmed Al
AA
Delaive
Kenneth
K
Walld
Randy
R
Manfreda
Jure
J
Kryger
Meir H
MH
D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000191:economics*; D003362:Cost-Benefit Analysis; D004569:Electroencephalography; D004576:Electromyography; D005500:Follow-Up Studies; D005102:Health Expenditures; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D017286:Polysomnography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*