Frequency and outcomes of primary central sleep apnea in a population-based study.
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ABSTRACT: Background
Primary central sleep apnea (PCSA) is believed to be rare and data regarding its prevalence and long-term outcomes are sparse. We used the Rochester Epidemiology Project (REP) resources to identify all Olmsted County, Minnesota, residents with an incident diagnosis of PCSA and their clinical outcomes.Methods
We searched the REP database for all residents with polysomnography (PSG)-confirmed diagnoses of central sleep apnea (CSA) between 2007 and 2015. From these, we reviewed the PSGs and medical records to find those who had PCSA based upon accepted diagnostic criteria. Data based on detailed review of the medical records, including all clinical notes and tests were recorded for analysis.Results
Of 650 patients identified with CSA, 25 (3.8%; 23 male) had PCSA, which was severe in most patients (n = 16, 64%). Of those, 23 (92%) patients were prescribed and 18/23 (78.2%) adherent to positive airway pressure therapy. Median duration of follow-up was 4.4 years (IQR:4.2). Four (16%) patients were subsequently diagnosed with cardiac arrhythmias, one (4%) with unstable angina, two (8%) with heart failure, five (20%) with mild cognitive impairment (MCI)/dementia and two (8%) with depression. Six (25%) patients died (median time to death = 5 years; IQR:4.8), three of whom had Lewy body dementia.Conclusions
In this population-based study, PCSA was rare and when present, was severe in a majority of patients. The mortality rate was high. Most frequently observed disorders during follow-up were mild cognitive impairment (MCI)/dementia followed by cardiac arrhythmias; it is possible that these entities were present and not recognized prior to the diagnosis of PCSA.
SUBMITTER: Kouri I
PROVIDER: S-EPMC9272740 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveAlthough obstructive sleep apnea (OSA) is not a life-threatening disease, very few studies have compared differences in healthcare service utilization between patients with and those without OSA in an Asian population according to different age groups. This study attempted to investigate differences in healthcare service utilization between patients with and those without OSA in different age groups in Taiwan.MethodsSampled subjects and data on their health service utilization were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. We included 568 patients with OSA and 2840 subjects without OSA. Each subject was followed for a 1-year period to evaluate their healthcare resource utilization. Wilcoxon-Mann-Whitney tests were performed to compare differences in healthcare utilization between patients with and those without OSA during the 1-year follow-up period.ResultsAs to all healthcare service utilization, patients with OSA had significantly more outpatient visits (30.3 vs. 18.6), outpatient costs (US$1231.2 vs. US$764.8), inpatient days (1.8 vs. 1.2), inpatient costs (US$563.6 vs. US$276.7), and total costs (US$1794.8 vs. US$1041.5) than comparison subjects during the 1-year follow-up period. Moreover, patients with OSA aged 40~49 and 50~59 years respectively incurred 2.11- and 2.02-fold higher total costs compared to patients without OSA. However, patients with OSA aged over 70 years did not have higher total costs compared to those without OSA.ConclusionsThis study found that patients with OSA had greater healthcare service utilization than those without OSA. Additionally, patients with OSA in the 40~49- and 50~59-year age groups had about 2-fold higher total costs of healthcare services than those without OSA.
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