The Effect of Obstructive Sleep Apnea on Morbidity and Health Care Utilization of Middle‐Aged and Older Adults
- 25 January 2008
- journal article
- research article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 56 (2), 247-254
- https://doi.org/10.1111/j.1532-5415.2007.01544.x
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.Keywords
This publication has 35 references indexed in Scilit:
- Gender and health care utilization: The role of mental distress and help-seeking propensitySocial Science & Medicine (1982), 2007
- Longitudinal Association of Sleep-Related Breathing Disorder and DepressionArchives of Internal Medicine, 2006
- Obstructive Sleep Apnea as a Risk Factor for Stroke and DeathThe New England Journal of Medicine, 2005
- Estimation of the determinants of household health care expenditures in Nepal with controls for endogenous illness and provider choiceHealth Economics, 2002
- Cardiovascular medication use in patients with undiagnosed obstructive sleep apnoeaThorax, 2002
- What Are Obstructive Sleep Apnea Patients Being Treated for Prior to This Diagnosis?Social psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2002
- Changes in Cognitive Function Associated with Sleep Disordered Breathing in Older PeopleJournal of the American Geriatrics Society, 2001
- How should cost data in pragmatic randomised trials be analysed?BMJ, 2000
- Sleep Apnea in Female Patients in a Nursing HomeSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1989
- Sleep apnea and mortality in an aged cohort.American Journal of Public Health, 1988