Impact of sleep apnea on direct societal and healthcare expenses in elderly patients: A nationwide register-based case-control study.

BACKGROUND

The demographic shift toward an aging population in Western societies increases healthcare demands. Obstructive sleep apnea (OSA), frequently underdiagnosed, is associated with health consequences. However, its broader economic impact on welfare and healthcare systems is inadequately quantified.

OBJECTIVE

To examine the direct societal and healthcare-related expenses following a diagnosis of OSA in elderly individuals.

METHODS

In this nationwide, register-based case-control study, individuals aged ≥65 years diagnosed with OSA between 2002 and 2019 were identified and matched 1:4 to controls by age, sex, cohabitation status, and municipality. Societal costs were defined as income from employment and public transfers. Healthcare costs were assessed using national healthcare registries. All financial data was adjusted to 2020 values.

RESULTS

A total of 21,555 elderly with OSA (mean age 71 years, 29.1 % female) were included and matched to 86,212 controls. During the year of diagnosis, 11.8 % of cases were employed, whereas 76.3 % received public pension. Compared to controls, OSA patients had significantly lower employment income (€23,102 vs. €23,810; p < 0.001 prior to, and €4381 vs €4486 (p < 0.001 after diagnosis) and higher public transfers. Healthcare costs nearly doubled in the index year compared to the preceding year, resulting in a net cost difference of €5219 per patient-year (p < 0.001)

CONCLUSIONS

Elderly patients with OSA incur substantially increased societal and healthcare-related costs compared to matched controls. Our findings underscore the need for early identification and treatment of OSA to potentially mitigate economic burden.