Reuveni H, Greenberg-Dotan S, Simon-Tuval T, Oksenberg A, Tarasiuk A
Sleep-Wake Disorders Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eur Respir J. 2008 Feb;31(2):273-9. doi: 10.1183/09031936.00097907. Epub 2007 Sep 26.
The aim of the present study was to explore morbidity and healthcare utilisation among young adult males with obstructive sleep apnoea (OSA) compared with middle-aged OSA patients over the 5-yr period preceding diagnosis. A prospective case-control study was performed; 117 young (22-39-yr-old) males with OSA were matched with 117 middle-aged (40-64-yr-old) OSA males for body mass index, apnoea/hypopnoea index, arterial oxygen saturation, arousal and awakening index, and Epworth Sleepiness Scale score. Each OSA patient was matched with controls by age, geographic area and physician. Young adult males with OSA showed no increase in specific comorbidity compared with controls. Middle-aged OSA patients exhibited increased risk of cardiovascular disease. Healthcare utilisation for the 5-yr period was >or=1.9 times higher among young and middle-aged male OSA patients than among controls. Multiple logistic regression analysis revealed that hyperlipidaemia in young adults and a body mass index of >37 kg x m(-2) and cardiovascular disease in middle-aged adults are the only independent determinants of the upper third, most costly, OSA patients. Compared with middle-aged males with obstructive sleep apnoea, in whom increased expenditure was related to cardiovascular disease and body mass index, utilisation was not related to any specific disease in younger cases.
本研究的目的是探讨与中年阻塞性睡眠呼吸暂停（OSA）患者相比，年轻成年男性OSA患者在诊断前5年期间的发病率和医疗保健利用率。进行了一项前瞻性病例对照研究；117名年轻（22 - 39岁）男性OSA患者与117名中年（40 - 64岁）男性OSA患者在体重指数、呼吸暂停/低通气指数、动脉血氧饱和度、觉醒和唤醒指数以及爱泼华嗜睡量表评分方面进行匹配。每名OSA患者按年龄、地理区域和医生与对照组进行匹配。与对照组相比，年轻成年男性OSA患者的特定合并症没有增加。中年OSA患者患心血管疾病的风险增加。年轻和中年男性OSA患者5年期间的医疗保健利用率比对照组高1.9倍或更高。多元逻辑回归分析显示，年轻成年人的高脂血症、体重指数＞37 kg·m⁻²以及中年成年人的心血管疾病是最昂贵的前三分之一OSA患者的唯一独立决定因素。与中年男性阻塞性睡眠呼吸暂停患者相比，中年患者费用增加与心血管疾病和体重指数有关，而年轻患者的利用率与任何特定疾病无关。
