Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Faculty of Health Sciences, University of Copenhagen, Glostrup Hospital, DK 2600 Glostrup, Denmark.
Thorax. 2011 Jul;66(7):560-6. doi: 10.1136/thx.2010.143958. Epub 2011 Jan 2.
The objective direct and indirect costs of sleep-disordered breathing (snoring, sleep apnoea (SA) and obesity hypoventilation syndrome (OHS)) and the treatment are incompletely described.
Using data from the Danish National Patient Registry (1998-2006), 12,045, 19,438 and 755 patients were identified with a diagnosis of snoring, SA and OHS, respectively. For every patient, four age-, sex- and socioeconomic-matched citizens were randomly selected (48,180, 77,752 and 3020, respectively) from the Danish Civil Registration System Statistics Direct costs were extracted from the Danish Ministry of Health, Danish Medicines Agency and National Health Security and indirect costs were based on data derived from the Coherent Social Statistics.
Snoring, and especially SA and OHS, were associated with significantly higher rates of health-related contact, medication use, unemployment and accounted for increased socioeconomic costs (especially indirect costs). These effects increased with the severity of SA and patients with OHS had the lowest employment rates. The income level of patients with SA and OHS who were employed was lower than that of employed control subjects. The annual excess total direct and indirect costs for patients with snoring, SA and OHS were €705, €3860 and €11,320, respectively. Patients with snoring, SA and OHS received an annual mean excess social transfer income of €147, €879 and €3263, respectively. These socioeconomic consequences were present up to 8 years prior to the first diagnosis in patients with SA and OHS, and further increased with disease advancement. Treatment with continuous positive airway pressure (CPAP) reduced mortality in patients with SA but not in those with OHS within an observation period of 2 years.
Sleep-disordered breathing has major socioeconomic consequences for the individual patient and for society. Although CPAP treatment reduces mortality, earlier disease detection could have a greater impact on disease complications.
睡眠呼吸障碍（打鼾、睡眠呼吸暂停（SA）和肥胖低通气综合征（OHS））及其治疗的直接和间接客观成本尚未完全描述。
利用丹麦国家患者登记处（1998-2006 年）的数据，分别确定了 12045、19438 和 755 例诊断为打鼾、SA 和 OHS 的患者。为每位患者，从丹麦民事登记系统统计数据中随机选择了 4 名年龄、性别和社会经济匹配的公民（分别为 48180、77752 和 3020）。直接成本从丹麦卫生部、丹麦药品管理局和国家健康保障局提取，间接成本基于从一致社会统计数据中得出的数据。
打鼾，尤其是 SA 和 OHS，与更高的健康相关接触率、药物使用率和失业率显著相关，并导致社会经济成本增加（尤其是间接成本）。这些影响随着 SA 的严重程度而增加，而 OHS 患者的就业率最低。患有 SA 和 OHS 的就业患者的收入水平低于就业对照组。患有 SA 和 OHS 的患者每年的总直接和间接超额费用分别为 705 欧元、3860 欧元和 11320 欧元。患有打鼾、SA 和 OHS 的患者每年平均获得的社会转移收入超额分别为 147 欧元、879 欧元和 3263 欧元。这些社会经济后果在 SA 和 OHS 患者首次诊断前长达 8 年就存在，并随着疾病的进展进一步增加。CPAP 治疗可降低 SA 患者的死亡率，但在观察期内 2 年内对 OHS 患者的死亡率没有影响。
睡眠呼吸障碍对患者个人和社会都有重大的社会经济影响。尽管 CPAP 治疗可降低死亡率，但早期发现疾病可能对疾病并发症产生更大的影响。
