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 Untreated Sleep Apnea Takes Heavy Medical, Financial Toll on Older Patients

Medical costs and the number of hospitalizations resulting from obstructive sleep apnea (OSA) hits older Americans much harder than for other age groups, according to new research by the University of Maryland School of Medicine as published first in the Journal of Clinical Sleep Medicine.

OSA is a relatively common medical condition that has been tied to wide range of health risks such as cardiovascular disease, stroke, depression, diabetes, and even premature death. When the condition is paired with older patients, researchers said there were substantially more drastic effects. And, researchers noted that OSA is especially common for older Americans in skilled nursing centers, with some 70 percent of residents affected by the condition.

To arrive at their findings, researchers conducted a review of a national sample of Medicare claims data, measuring the health care costs over a year among Medicare beneficiaries who were 65 years and older and were ultimately diagnosed with OSA.

They found that patients who went undiagnosed with OSA over a 12-month period had more doctors’ appointments, emergency room visits, and hospital stays prior to being treated for the disorder. On average, these patients had nearly $20,000 more in costs a year than those who were diagnosed and treated for OSA, according to the report.

“Sleep disorders represent a massive economic burden on the U.S. health care system,” said Emerson Wickwire, PhD, associate professor of psychiatry and medicine at the school. He noted that the economic aspects of diseases are increasingly recognized as important drivers of health decisions by patients, those paying for services, policymakers, and, ultimately, the taxpayers.

“We conducted the largest economic analysis of sleep apnea among older adults to date,” he said. “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. 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."

Researchers also observed that Medicare patients with OSA were more likely to suffer from other ailments than individuals without the sleep disorder. For example, OSA is linked to an increased risk for high blood pressure, diabetes, heart disease, stroke, and depression.

Study authors suggest that insurers, legislators, and health systems consider routine screening for OSA in older patients—especially those with medical and psychiatric comorbidities—to better contain costs. “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 disorder treatments to improve outcomes and reduce costs associated with sleep disorders," Wickwire said.

This new research follows a 2016 report by the American Academy of Sleep Medicine that estimated undiagnosed OSA among U.S. adults costs $149.6 billion annually. While the report projected it would cost the health care system nearly $50 billion to diagnose and treat every American adult with OSA, treatment would produce savings of $100 billion.

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