title: Utilization of healthcare resources in obstructive sleep apnea syndrome: a 5-year follow-up study in men using CPAP.
abstract: 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.
authors.affiliation: Sleep Disorders Center, St Boniface General Hospital, Section of Respiratory Diseases, Winnipeg, Manitoba, Canada.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Albarrak
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Banno
authors.forename: Ahmed Al
authors.initials: AA
authors.lastname: Sabbagh
authors.forename: Kenneth
authors.initials: K
authors.lastname: Delaive
authors.forename: Randy
authors.initials: R
authors.lastname: Walld
authors.forename: Jure
authors.initials: J
authors.lastname: Manfreda
authors.forename: Meir H
authors.initials: MH
authors.lastname: Kryger
mesh_terms: 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*