Utilization of healthcare resources in obstructive sleep apnea syndrome: a 5-year follow-up study in men using CPAP

Sleep. 2005 Oct;28(10):1306-11. doi: 10.1093/sleep/28.10.1306.


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 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.

MeSH terms

  • Adult
  • Continuous Positive Airway Pressure / economics*
  • Cost-Benefit Analysis
  • Electroencephalography
  • Electromyography
  • Follow-Up Studies
  • Health Expenditures
  • Health Services / economics*
  • Health Services / statistics & numerical data*
  • Humans
  • Male
  • Manitoba
  • Middle Aged
  • Polysomnography
  • Retrospective Studies
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / economics*
  • Sleep Apnea, Obstructive / therapy*