The medical cost of undiagnosed sleep apnea

Obstructive sleep apnea is an under-diagnosed, but common disorder with ser ious adverse consequences. Cost data from the year prior to the diagnosis o f sleep-disordered breathing in a consecutive series of 238 cases were used to estimate the potential medical cost of undiagnosed sleep apnea and to d etermine the relationship between the severity of sleep-disordered breathin g and the magnitude of medical costs. Among cases, mean annual medical cost prior to diagnosis was $2720 versus $1384 for age and gender matched contr ols (p<0.01). Regression analysis showed that the reciprocal of the apnea h ypopnea index among cases was significantly related to log-transformed annu al medical costs after adjusting for age, gender, and body mass index (p<0. 05). We conclude that patients with undiagnosed sleep apnea had considerabl y higher medical costs than age and sex matched individuals and that the se verity of sleep-disordered breathing was associated with the magnitude of m edical costs. Using available data on the prevalence of undiagnosed moderat e to severe sleep apnea in middle-aged adults, we estimate that untreated s leep apnea may cause $3.4 billion in additional medical costs in the U.S. W hether medical cost savings occur with treatment of sleep apnea remains to be determined.