• Qian Cai, Hiangkiat Tan, and Joseph Singer.
• HealthCore, Inc, 800 Delaware Ave, 5th Fl, Wilmington, DE 19801-1366, USA. ccai@healthcore.com
• Am J Manag Care. 2012 Jun 1; 18 (6): e225-33.

ObjectivesTo evaluate the clinical and economic impact of positive airway pressure (PAP) among patients with obstructive sleep apnea (OSA).Study DesignRetrospective claims-based analysis of OSA patients diagnosed with polysomnography (PSG) between January 1, 2005, and April 30, 2008.MethodsPatients were required to have 2 or more claims for OSA diagnosis within 1 year after their first PSG test, and a minimum of 12 months' baseline and 24 months' follow-up continuous health plan enrollment. Patients with pulmonary disease or PAP use before the first PSG test were excluded. Outcomes included all-cause and sleep apnea-related hospitalization and healthcare costs. Multivariable analyses were performed to adjust for baseline characteristics.ResultsOf the 15,424 patients identified, 90.7% used PAP and 9.3% did not. The PAP group had lower all-cause (19.0% vs 24.2%, P <.001) and sleep apnea-related (8.0% vs 11.3%, P <.001) hospitalization rates than the non-PAP group during the follow-up period. After adjusting for baseline characteristics, patients in the PAP group were less likely to have an all-cause (odds ratio [OR] 0.70; 95% confidence interval [CI] 0.61-0.80]) or sleep apnea-related (OR 0.69; 95% CI 0.58-0.83) hospitalization than non-PAP patients. PAP users on average incurred 10% lower all-cause costs than non-PAP patients ($705 per member per month vs $786 per member per month, P <.001) in multivariable analysis.ConclusionsAmong OSA patients in real-world practice, PAP users had significantly lower hospitalization risks and all-cause healthcare costs.

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