Consequences of Untreated OSA

Health Impact

• Sleep-disordered breathing (SDB) has frequently been associated
  with various forms of cardiovascular disease
  
  
• Individuals with severe SDB are two- to four-times more likely to
  develop complex arrhythmias than those without SDB¹
  
  
• Individuals with diagnosed OSA are between two and three times
  more likely to develop hypertension²
  
  
• The prevalence of OSA in patients with heart failure is estimated at
  40 to 70 percent^{3, 4}
  
  
• Individuals with diagnosed OSA are more likely to suffer a stroke
  than those without OSA^{5, 6, 7}
  
  
• JNC7 recognizes OSA as an identifiable cause of hypertension⁸
  
  
• Type 2 diabetes is more prevalent in patients with sleep-disordered
  breathing independent of other risk factors⁹
  
  
• The American Society of Anesthesiologists (ASA) recommends identifying,
  monitoring, and treating patients with OSA in the perioperative period¹⁰
  
  

Economic Impact
Several studies review the impact of undiagnosed OSA from an economic perspective. Studies compared patients without OSA to patients with OSA who were either undiagnosed or untreated.

Patients with undiagnosed or untreated OSA:

• Had twice the healthcare costs than those without OSA.^{11, 12}
• Had an estimated 50 percent more physician visits and incurred 50 percent more physician costs than those without OSA.^{11, 12}
• Spent longer in the hospital setting compared to those without OSA.^{11, 12}

Average physician claims for 181 patients versus control subjects for the 10 years prior to diagnosis with OSAS. Difference between groups indicated by asterisk.¹²

¹Mehra, R., et al., AJRCCM2006 :173:910-916
²Peppard, et al., NEJM2000:342:1378-1384
³Javahari, S., Cur Treat Options in CV Med2005:7:295-306
⁴Sin, D., et al., AJRCCM1999:160:1101-1106
⁵Goldstein, L.B., et al., Stroke2006:37:1583-1633
⁶Yaggi, H.K., et al., NEJM2005:353 :2034-2041
⁷Arzt, M., et al., AJRCCM2005:172:1447-1451
⁸Chobanian, A.V., et al., J Hypertension2003:42:1206-1252
⁹Reichmuth, et al., AJCRRCM2005:172:1590-1595
¹⁰Practice Guidelines, Anesthesiology2006:104(5):1081-1093
¹¹Bahammam, A., et al., Sleep1999:22(6):740-747
¹²Ronald, J., et al., Sleep1999:22(2):225-229