1Sleep Disorders Center, St. Boniface General Hospital, Section of Respiratory Diseases, and 2Manitoba Centre for Health Policy and Evaluation, University of Manitoba, Winnipeg, Manitoba, Canada
Study Objectives: 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.
Design: Retrospective observational cohort study.
Subjects: 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.
Interventions: 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 $148.65±$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 $13.92±$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.
Keywords: Sleep, apnea, medical economics, epidemiology, healthcare utilization, CPAP compliance
Citation: Albarrak M; Banno K; Sabbagh AA et al. Utilization of healthcare resources in obstructive sleep apnea syndrome: a 5-year follow-up study in men using CPAP. SLEEP 2005;28(10): 1306-1311.
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