Skip to main content

Advertisement

SpringerLink
Log in

The Economic Impact of Obstructive Sleep Apnea

  • State of the Art Review
  • Published:
Lung Aims and scope Submit manuscript

Abstract

Untreated obstructive sleep apnea (OSA) increases healthcare utilization and is associated with reduced work performance and occupational injuries. The economic burden related to untreated OSA is substantial, accounting for billions of dollars per year. Furthermore, therapy of OSA is an extremely cost-efficient use of healthcare resources, comparing highly favorably with other commonly funded medical therapies. Governments, transportation agencies, industry, and insurance companies need to be better informed concerning the economic impact of untreated OSA and the benefits of therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 32:1230–1235

    Article  Google Scholar 

  2. Ip M, Chung KF, Chan KN, Lam SP, Lee K (1999) Previously unrecognized obstructive sleep apnea in Chinese subjects with essential hypertension. Lung 177(6):391–400

    Article  PubMed  CAS  Google Scholar 

  3. Shamsuzzaman ASM, Gersh BJ, Somers V (2003) Obstructive sleep apnea – implications for cardiac and vascular disease. JAMA 290(14):1906-1919

    Article  PubMed  CAS  Google Scholar 

  4. Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea – a population health perspective. Am J Respir Crit Care Med 165:1217–1239

    Article  PubMed  Google Scholar 

  5. Grunstein RR, Stenlof K, Hedner JA, Sjostrom L (1995) Impact of self-reported sleep-breathing disturbances on psychosocial performance in the Swedish Obese Subjects (SOS) study. Sleep 18:635–643

    PubMed  CAS  Google Scholar 

  6. Ulfberg J, Carter N, Talback M, Edling C (1996) Excessive daytime sleepiness at work and subjective work performance in the general population and among heavy snorers and patients with obstructive sleep apnea. Chest 110:659–663

    Article  PubMed  CAS  Google Scholar 

  7. Mulgrew AT, Ryan CF, Fleetham JA, Cheema R, Fox N, Koehoorn M, FitzGerald JM, Marra C, Ayas NT (2007) The impact of obstructive sleep apnea and daytime sleepiness on work limitation. Sleep Med [epub ahead of print]

  8. Lerner D, Amick BC, Lee JC, Rooney T, Rogers WH, Chang H, Berndt ER (2003) Relationship of employee-reported work limitations to work productivity. Med Care 41(5):649–659

    Article  PubMed  Google Scholar 

  9. Ulfberg J, Jonsson R, Edling C (1999) Improvement of subjective work performance among obstructive sleep apnea patients after treatment with continuous positive airway pressure. Psychiatry Clin Neurosci 53(6):677–679

    Article  PubMed  CAS  Google Scholar 

  10. Scharf MB, Stover R, McDannold MD, Spinner O, Berkowitz DV, Conrad C (1999) Outcome evaluation of long-term nasal continuous positive airway pressure therapy in obstructive sleep apnea. Am J Ther 6(6):293–297

    Article  PubMed  CAS  Google Scholar 

  11. Arai H, Furuta H, Kosaka K, Kaneda R, Koshino Y, Sano J, Kumagai S, Yamamoto E (1998) Changes in work performances in obstructive sleep apnea patients after dental appliance therapy. Psychiatry Clin Neurosci 52(2):224–225

    Article  PubMed  CAS  Google Scholar 

  12. Patel SR, White DP, Malhotra A, Stanchina ML, Ayas NT (2003) Continuous positive airway pressure therapy for treating sleepiness in a diverse population with obstructive sleep apnea: results of a meta-analysis. Arch Intern Med 163(5):565–571

    Article  PubMed  Google Scholar 

  13. Anon (2007) Fatal Occupational Injuries—United States, 2005. MMWR Morbid Mortal Wkly Rep 56(13):297–301

    Google Scholar 

  14. Chouri-Pontarollo N, Borel JC, Tamisier R, Wuyam B, Levy P, Pepin JL (2007) Impaired objective daytime vigilance in obesity-hypoventilation syndrome: impact of noninvasive ventilation. Chest 131(10):148–155

    Article  PubMed  Google Scholar 

  15. Howard ME, Desai AV, Grunstein RR, Hukins C, Armstrong JG, Joffe D, Swann P, Campbell DA, Pierce RJ (2004) Sleepiness, sleep-disordered breathing, and accident risk factors in commercial vehicle drivers. Am J Respir Crit Care Med 170(9):1014–1021

    Article  PubMed  Google Scholar 

  16. Ulfberg J, Carter N, Edling C (2000) Sleep-disordered breathing and occupational accidents. Scand J Work Environ Health 26(3):237–242

    PubMed  CAS  Google Scholar 

  17. Lindberg E, Carter N, Gislason T, Janson C (2001) Role of snoring and daytime sleepiness in occupational accidents. Am J Respir Crit Care Med 164:2031–2035

    PubMed  CAS  Google Scholar 

  18. Spengler SE, Browning SR, Reed DB (2004) Sleep deprivation and injuries in part-time Kentucky farmers: impact of self reported sleep habits and sleep problems on injury risk. Am Assoc Occup Health Nurses J 52(9):373–382

    Google Scholar 

  19. George CF (2001) Reduction in motor vehicle collisions following treatment of sleep apnoea with nasal CPAP. Thorax 56:508–512

    Article  PubMed  CAS  Google Scholar 

  20. Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J (1999) The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med 340(11):847–851

    Article  PubMed  CAS  Google Scholar 

  21. Sassani A, Findley LJ, Kryger M, Goldlust E, George C, Davidson TM (2004) Reducing motor-vehicle collisions, costs, and fatalities by treating obstructive sleep apnea syndrome. Sleep 27(3):453–458

    PubMed  Google Scholar 

  22. Hillman DR, Murphy AS, Antic R, Pezzullo L (2006) The economic cost of sleep disorders. Sleep 29(3):299–305

    PubMed  Google Scholar 

  23. Beasley R (2002) The burden of asthma with specific reference to the United States. J Allergy Clin Immunol 109:S482–S489

    Article  PubMed  Google Scholar 

  24. Mannino DM, Braman S (2007) The epidemiology and economics of chronic obstructive pulmonary disease. Proc Am Thorac Soc 4:502–506

    Article  PubMed  Google Scholar 

  25. American Diabetes Association (2003) Economic costs of diabetes in the U.S. in 2002. Diabetes Care 26:917–932

    Article  Google Scholar 

  26. Bahammam A, Delaive K, Ronald J, Manfreda J, Roos L, Kryger MH (1999) Health care utilization in males with obstructive sleep apnea syndrome two years after diagnosis and treatment. Sleep 22(6):740–747

    PubMed  CAS  Google Scholar 

  27. Kapur V, Blough DK, Sandblom RE, Hert R, de Maine JB, Sullivan SD, Psaty BM (1999) The medical cost of undiagnosed sleep apnea. Sleep 22(6):749–755

    PubMed  CAS  Google Scholar 

  28. Tarasiuk A, Greenberg-Dotan S, Brin YS, Simon T, Tal A, Reuveni H (2005) Determinants affecting health-care utilization in obstructive sleep apnea syndrome patients. Chest 128:1310–1314

    Article  PubMed  Google Scholar 

  29. Albarrak M, Banno K, Sabbagh AA, Delaive K, Walld R, Manfreda J, Kryger MH (2005) Utilization of healthcare resources in obstructive sleep apnea syndrome: a 5-year follow-up study in men using CPAP. Sleep 28(10):1306–1311

    PubMed  Google Scholar 

  30. Ubel PA, Hirth RA, Chernew ME, Fendrick AM (2003) What is the price of life and why doesn’t it increase at the rate of inflation? Arch Intern Med 163(14):1637–1641

    Article  PubMed  Google Scholar 

  31. Tousignant P, Cosio MG, Levy RD, Groome PA (1994) Quality adjusted life years added by treatment of obstructive sleep apnea. Sleep 17(1):52–60

    PubMed  CAS  Google Scholar 

  32. Mar J, Rueda JR, Duran-Cantolla J, Schechter C, Chilcott J (2003) The cost-effectiveness of nCPAP treatment in patients with moderate-to-severe obstructive sleep apnoea. Eur Respir J 21(3):515–522

    PubMed  CAS  Google Scholar 

  33. Ayas NT, Fitzgerald M, Fleetham JA, White DP, Schultzer M Ryan F, Ghaeli R, Mercer GW, Cooper P, Tan MCY, Marra CA (2006) Cost-effectiveness of continuous positive airway pressure therapy for moderate to severe obstructive sleep apnea/hypopnea. Arch Intern Med 166:977–984

    Article  PubMed  Google Scholar 

  34. Tan MC, Ayas NT, Mulgrew A, Cortes L, FitzGerald JM, Fleetham JA, Schulzer M, Ryan CF, Ghaeli R, Cooper P, Marra CA (2007) Cost-effectiveness of CPAP therapy for obstructive sleep apnea hypopnea in British Columbia. Can Respir J (in press)

  35. Parish JM, Lyng PJ (2003) Quality of life in bed partners of patients with obstructive sleep apnea or hypopnea after treatment with continuous positive airway pressure. Chest 124(3):942–947

    Article  PubMed  Google Scholar 

  36. Prosser LA, Stinnett AA, Goldman PA, Williams LW, Hunink MG, Goldman L, Weinstein MC (2000) Cost-effectiveness of cholesterol-lowering therapies according to selected patient characteristics. Ann Intern Med 132(10):769–779

    PubMed  CAS  Google Scholar 

  37. Wong JB (2004) Cost-effectiveness of anti-tumor necrosis factor agents. Clin Exp Rheumatol 22(5 Suppl 35):S65–S70

    PubMed  CAS  Google Scholar 

  38. Ramsey SD, Berry K, Etzioni R, Kaplan RM, Sullivan SD, Wood DE, National Emphysema Treatment Trial Research Group (2003) Cost effectiveness of lung-volume-reduction surgery for patients with severe emphysema. N Engl J Med 348(21):2092–2102

    Article  PubMed  Google Scholar 

  39. Jenkinson C, Davies RJ, Mullins R, Stradling JR (1999) Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomized prospective parallel trial. Lancet 353(9170):2100–2105

    Article  PubMed  CAS  Google Scholar 

  40. Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046–1053

    PubMed  Google Scholar 

  41. Flemons WW, Douglas NJ, Kuna ST, Rodenstein DO, Wheatley J (2004) Access to diagnosis and treatment of patients with suspected sleep apnea. Am J Respir Crit Care Med 169:668–672

    Article  PubMed  Google Scholar 

  42. Fleetham J, Ayas N, Bradley D, Ferguson K, Fitzpatrick M, George C, Hanley P, Hill F, Kimoff J, Kryger M, Morrison D, Series F, Tsai W (2006) Canadian Thoracic Society Guidelines: Diagnosis and treatment of sleep disordered breathing in adults. Can Respir J 13(7):387–392

    PubMed  Google Scholar 

  43. Mulgrew AT, Fox N, Ayas NT, Ryan CF (2007) Ambulatory clinical algorithm for diagnosis and CPAP titration in obstructive sleep apnea: a randomized controlled trial. Ann Intern Med 146:157–166

    PubMed  Google Scholar 

  44. Kulasingam SL, Myers ER (2003) Potential health and economic impact of adding a human papillomavirus vaccine to screening programs. JAMA 290:781–789

    Article  PubMed  Google Scholar 

  45. Briggs AH, Lozano-Ortega G, Spencer S, Bale G, Spencer MD, Burge PS (2006) Estimating the cost-effectiveness of fluticasone propionate for treating chronic obstructive pulmonary disease in the presence of missing data. Value Health 9:227–235

    Article  PubMed  Google Scholar 

  46. Vergel YB, Palmer S, Asseburg C, Fenwick E, de Belder M, Abrams K, Sculpher M (2007) Is primary angioplasty cost effective in the UK? Results of a comprehensive decision analysis. Heart 93:1238–1243

    Article  Google Scholar 

  47. Sanders GD, Hlatky MA, Owens DK (2005) Cost-effectiveness of implantable cardioverter-defibrillators. N Engl J Med 353:1471–1480

    Article  PubMed  CAS  Google Scholar 

  48. Cox CE, Carson SS, Govert JA, Chelluri L, Sanders GD (2007) An economic evaluation of prolonged mechanical ventilation. Crit Care Med 35:1918–1927

    Article  PubMed  Google Scholar 

  49. NETT Investigators (2003) Cost-effectiveness of lung volume reduction surgery for patients with severe emphysema. N Engl J Med 348:2092–2102

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Nayef AlGhanim, Vikram R. Comondore, John Fleetham & Najib T. Ayas

  2. Sleep Disorders Program, University of British Columbia, Vancouver, British Columbia, Canada

    John Fleetham & Najib T. Ayas

  3. Respiratory Division, Vancouver General Hospital, Vancouver, British Columbia, Canada

    John Fleetham & Najib T. Ayas

  4. Centre Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada

    Najib T. Ayas

  5. Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada

    Carlo A. Marra

  6. Respiratory Medicine, 7th Floor, Gordon and Leslie Diamond Health Care Centre, 2775 Laurel St, V5Z 1M9, Vancouver, BC, Canada

    Najib T. Ayas

Authors
  1. Nayef AlGhanim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vikram R. Comondore
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John Fleetham
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carlo A. Marra
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Najib T. Ayas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Najib T. Ayas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

AlGhanim, N., Comondore, V.R., Fleetham, J. et al. The Economic Impact of Obstructive Sleep Apnea. Lung 186, 7–12 (2008). https://doi.org/10.1007/s00408-007-9055-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00408-007-9055-5

Keywords

Search

Navigation