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The Effect of Obstructive Sleep Apnea on Morbidity and Health Care Utilization of Middle‐Aged and Older Adults
Author(s) -
Tarasiuk Ariel,
GreenbergDotan Sari,
SimonTuval Tzahit,
Oksenberg Arie,
Reuveni Haim
Publication year - 2008
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2007.01544.x
Subject(s) - medicine , obstructive sleep apnea , polysomnography , odds ratio , confidence interval , body mass index , middle age , pediatrics , sleep apnea , logistic regression , health care , emergency medicine , physical therapy , apnea , economics , economic growth
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.