Untreated Obstructive Sleep Apnea Results in Higher Costs, Healthcare Utilization

Individuals with untreated obstructive sleep apnea (OSA) have increased health care utilization (HCU) and costs across all points of service, according to results of a recent study published by the Journal of Clinical Sleep Medicine.

The study involved a random 5% sample of Medicare administrative claims data from the years 2006 through 2013. The researchers determined if an individual had OSA by their receipt of 1 or more Clinical Modification diagnostic codes outlined in the International Classification of Disease, Ninth Revision. Additional determinations were made based on a patient’s initiation of OSA treatment, either with continuous positive airway pressure or oral appliance therapy.

Researchers evaluated HCU and costs over the course of 12 months leading up to treatment initiation. This data was compared between beneficiaries with OSA and matched control patients without the condition.

"Sleep disorders represent a massive economic burden on the U.S. health care system," said Emerson Wickwire, PhD, a lead author of the study and associate professor of psychiatry and medicine at the University of Maryland. “Medicare beneficiaries with obstructive sleep apnea cost taxpayers an additional $19,566 per year and utilized more outpatient, emergency, inpatient, prescription, and overall health care services,” he said.

Wickwire continued, “It's important to realize that costs associated with untreated sleep disorders are likely to continue to accrue year after year, which is why our group focuses on early recognition and treatment."

The results included a final sample consisting of 10,317 beneficiaries with OSA and 276,874 control patients.

In the year prior to OSA diagnosis, beneficiaries with OSA increased their HCU and had higher mean total annual costs ($19,566, 95% confidence interval [CI] $13,239, $25,894). Results also demonstrated an increase in annual costs across all individual points of service. Researchers reported that inpatient care was associated with the highest incremental costs when compared to control patients ($15,482, 95% CI $8,521, $22,443).

"The good news is that highly effective diagnostic and treatment strategies are available. Our team is currently using big data approaches as well as highly personalized sleep disorders treatments to improve outcomes and reduce costs associated with sleep disorders," said Wickwire.

Researchers emphasized the importance of early detection and treatment of disorders like OSA, especially in older adults who already face higher risks of other serious illnesses. Specifically, OSA is associated with an increased risk of high blood pressure, diabetes, depression, and other conditions.

Reference:

Wickwire EM, Tom SE, Vadlamani A, et al. Older adult US Medicare beneficiaries with untreated obstructive sleep apnea are heavier users of health care than matched control patients [published online January 15, 2020]. J Clin Sleep Med. doi: 10.5664/jcsm.8128.