The effect of obstructive sleep apnea on morbidity and health care utilization of middle-aged and older adults.

Source

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

Abstract

OBJECTIVES:

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.

DESIGN:

Case-control study between January 2001 and April 2003.

SETTING:

Two sleep-wake disorders centers.

PARTICIPANTS:

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.

MEASUREMENTS:

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.

CONCLUSION:

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.

J Am Geriatr Soc. 2008 Feb;56(2):247-54