The effect of obstructive sleep apnea on morbidity and health care utilization of middle-aged and older adults.
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.
Tarasiuk
Ariel
A
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
Greenberg-Dotan
Sari
S
Simon-Tuval
Tzahit
T
Oksenberg
Arie
A
Reuveni
Haim
H
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