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Editorials |16 March 1999

Economic Implications of the Diagnosis of Obstructive Sleep Apnea

Allan I. Pack, MB, ChB, PhD; Indira Gurubhagavatula, MD, MPH

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  • University of Pennsylvania Medical Center; Philadelphia, PA 19104-4283
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The past decade has witnessed considerable accumulation of evidence indicating just how common the obstructive sleep apnea syndrome is. The most definitive study to date, the Wisconsin Sleep Cohort Study, estimates that 4% of middle-aged adult men and 2% of middle-aged adult women have symptomatic sleep apnea (1). Prevalence rates in persons older than 65 years are even higher (2). Moreover, evidence of morbidity associated with this condition is growing. Obstructive sleep apnea causes excessive daytime sleepiness (3, 4), and, in prospective studies, an increased risk for vehicular crashes has been demonstrated in men (5). Sleep apnea is a risk factor for cardiovascular conditions, although data supporting this assertion have been received with some skepticism (6). Recently, however, the large, multicenter Sleep Heart Study demonstrated in initial cross-sectional analyses an increased risk for hypertension in persons with sleep apnea, particularly those younger than 60 years of age, even after controlling for common confounders (such as obesity) (Samet J. Personal communication; 1998).
Sleep apnea is a chronic condition, and an estimated 80% to 90% of persons with obstructive sleep apnea have not received a clinical diagnosis (7). This large number of presumed patients in whom the condition is undiagnosed presents a challenge to any health care delivery system. The growing recognition of this disorder has led to an increased demand for services. In one health maintenance organization (Group Health Cooperative of Puget Sound), the rate of polysomnographies increased from 91.7 to 205.3 per 100 000...
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Pack AI, Gurubhagavatula I. Economic Implications of the Diagnosis of Obstructive Sleep Apnea. Ann Intern Med. 1999;130:533–534. doi: 10.7326/0003-4819-130-6-199903160-00019

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Published: Ann Intern Med. 1999;130(6):533-534.

DOI: 10.7326/0003-4819-130-6-199903160-00019

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