title: The effect of obstructive sleep apnea on morbidity and health care utilization of middle-aged and older adults.
abstract: OBJECTIVE
  To determine whether elderly subjects with obstructive sleep apnea (OSA) had different morbidity and health care utilization than elderly subjects without OSA and middle-aged patients with OSA 2 years before diagnosis.
  
  
  METHODS
  Case-control study between January 2001 and April 2003.
  
  
  METHODS
  Two sleep-wake disorders centers.
  
  
  METHODS
  One hundred fifty-eight elderly and 1,166 middle-aged (aged 67-89 and 40-64, respectively) patients with OSA were matched 1:1 with healthy controls according to age, sex, geographic area, and primary physician.
  
  
  METHODS
  Polysomnography, medical diagnoses, and healthcare utilization.
  
  
  RESULTS
  Healthcare costs 2 years before diagnosis were more than 1.8 times as high for elderly and middle-aged patients with OSA as for controls (P<.001). Expenditures of elderly patients with OSA were 1.9 times as high as for middle-aged patients with OSA (P<.001). Multiple logistic regression analysis (adjusting for age, body mass index, and apnea hypopnea index) revealed that cardiovascular disease (CVD) (odds ratio (OR)=4.1, 95% confidence interval (CI)=1.8-9.3) and use of psychoactive drugs (OR=3.8, 95% CI=1.5-10.1) are independent determinants for the top-third most-costly elderly patients with OSA.
  
  
  CONCLUSIONS
  Elderly patients with OSA have high healthcare utilization because of CVD morbidity and use of psychoactive medications. Therefore, OSA has clinical significance in elderly people.
authors.affiliation: Sleep-Wake Disorders Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. tarasiuk@bgu.ac.il
authors.forename: Ariel
authors.initials: A
authors.lastname: Tarasiuk
authors.forename: Sari
authors.initials: S
authors.lastname: Greenberg-Dotan
authors.forename: Tzahit
authors.initials: T
authors.lastname: Simon-Tuval
authors.forename: Arie
authors.initials: A
authors.lastname: Oksenberg
authors.forename: Haim
authors.initials: H
authors.lastname: Reuveni
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000191:economics* / Q000453:epidemiology*; D011795:Surveys and Questionnaires