Elevated economic burden in obstructive lung disease patients with concomitant sleep apnea syndrome

Sleep Breath. 2009 Nov;13(4):317-23. doi: 10.1007/s11325-009-0266-2. Epub 2009 May 30.


Purpose: The purpose of this study is to examine the incremental economic burden of sleep apnea syndrome (SAS) among individuals with concomitant asthma, chronic obstructive pulmonary disease (COPD), or both (i.e., asthma/COPD).

Methods: Maryland Medicaid claims data were used to identify beneficiaries with asthma (n = 3,072), COPD (n = 3,455), or both (n = 2,604). We compared patient's baseline characteristics by SAS and stratified the analyses by disease cohort to examine the effect of SAS on medical utilization and cost.

Results: SAS was more prevalent among beneficiaries with asthma/COPD (6.72%) than beneficiaries with COPD alone (2.87%) or asthma alone (2.15%). Asthma/COPD and COPD beneficiaries with SAS had more medical service claims (p < 0.001) and higher medical cost than beneficiaries without SAS: $5,773 and $4,155 in excess costs among asthma/COPD (p = 0.037) and COPD patients (p = 0.035), respectively. Medical utilization and cost did not differ by SAS in asthma patients (p = 0.567).

Conclusions: SAS may add additional economic burden on beneficiaries who already have COPD or asthma/COPD.

MeSH terms

  • Adult
  • Asthma / complications
  • Asthma / economics*
  • Asthma / therapy
  • Cohort Studies
  • Comorbidity
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Male
  • Managed Care Programs / economics
  • Managed Care Programs / statistics & numerical data
  • Maryland
  • Medicaid / economics
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / economics*
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Sleep Apnea, Obstructive / complications
  • Sleep Apnea, Obstructive / economics*
  • Sleep Apnea, Obstructive / therapy
  • United States
  • Utilization Review