Health care utilization in the 10 years prior to diagnosis in obstructive sleep apnea syndrome patients

Obstructive sleep apnea syndrome (OSAS) patients may have symptoms for year s prior to recognition of their disorder, or they may be treated for the as sociated comorbidities. We hypothesized that such patients would be heavy c onsumers of health care resources for several years prior to diagnosis. We therefore compared health service utilization for a 10-year interval prior to diagnosis of 181 OSA patients to those of randomly selected age-, gender -, and geographically matched controls from the general population. OSAS pa tients used approximately twice as many health care services (as defined by physician claims and overnight stays in hospital) in the 10 years prior to their initial diagnostic evaluation for apnea. Physician claims for the OS A patients totaled $686,365 ($3972 per patient), compared to $356,376 ($196 9 per patient) for the controls for the 10-year period examined in this stu dy. Use of health services was significantly higher in 7 of 10 years prior to diagnosis. The OSAS patients also had more overnight hospitalizations: t hey spent 1118 nights (6.2 per patient) in hospital vs 676 nights (3.7 per patient) for controls in the decade prior to diagnosis. We conclude that by the time patients are finally diagnosed for sleep apnea, they have already been heavy users of health services for several years. It is possible that our findings reflect not OSAS per se, but the presence of some of the risk factors that predispose to OSAS, such as obesity, alcohol usage and perhap s tobacco consumption.