Tarasiuk Ariel, Greenberg-Dotan Sari, Simon-Tuval Tzahit, Oksenberg Arie, Reuveni Haim
Sleep-Wake Disorders Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
J Am Geriatr Soc. 2008 Feb;56(2):247-54. doi: 10.1111/j.1532-5415.2007.01544.x.
To determine whether elderly subjects with obstructive sleep apnea (OSA) had different morbidity and health care utilization than elderly subjects without OSA and middle-aged patients with OSA 2 years before diagnosis.
Case-control study between January 2001 and April 2003.
Two sleep-wake disorders centers.
One hundred fifty-eight elderly and 1,166 middle-aged (aged 67-89 and 40-64, respectively) patients with OSA were matched 1:1 with healthy controls according to age, sex, geographic area, and primary physician.
Polysomnography, medical diagnoses, and healthcare utilization.
Healthcare costs 2 years before diagnosis were more than 1.8 times as high for elderly and middle-aged patients with OSA as for controls (P<.001). Expenditures of elderly patients with OSA were 1.9 times as high as for middle-aged patients with OSA (P<.001). Multiple logistic regression analysis (adjusting for age, body mass index, and apnea hypopnea index) revealed that cardiovascular disease (CVD) (odds ratio (OR)=4.1, 95% confidence interval (CI)=1.8-9.3) and use of psychoactive drugs (OR=3.8, 95% CI=1.5-10.1) are independent determinants for the top-third most-costly elderly patients with OSA.
Elderly patients with OSA have high healthcare utilization because of CVD morbidity and use of psychoactive medications. Therefore, OSA has clinical significance in elderly people.
确定患有阻塞性睡眠呼吸暂停（OSA）的老年受试者与未患OSA的老年受试者以及诊断前2年的中年OSA患者相比，是否具有不同的发病率和医疗保健利用率。
2001年1月至2003年4月的病例对照研究。
两个睡眠-觉醒障碍中心。
158名老年（年龄分别为67 - 89岁）和1166名中年（年龄为40 - 64岁）OSA患者，根据年龄、性别、地理区域和初级医生与健康对照进行1:1匹配。
多导睡眠图、医学诊断和医疗保健利用率。
诊断前2年，老年和中年OSA患者的医疗费用是对照组的1.8倍以上（P <.001）。老年OSA患者的支出是中年OSA患者的1.9倍（P <.001）。多因素逻辑回归分析（调整年龄、体重指数和呼吸暂停低通气指数）显示，心血管疾病（CVD）（比值比（OR）=4.1，95%置信区间（CI）=1.8 - 9.3）和使用精神活性药物（OR = 3.8，95% CI = 1.5 - 10.1）是老年OSA患者中医疗费用最高的三分之一患者的独立决定因素。
老年OSA患者由于CVD发病率和使用精神活性药物而具有较高的医疗保健利用率。因此，OSA在老年人中具有临床意义。
