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Updated: May 20, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Impact of positive airway pressure among obstructive sleep apnea patients
Qian Cai1, Hiangkiat Tan, Joseph Singer
1HealthCore, Inc, 800 Delaware Ave, 5th Fl, Wilmington, DE 19801-1366, USA. ccai@healthcore.com
Objectives:
To evaluate the clinical and economic impact of positive airway pressure (PAP) among patients with obstructive sleep apnea (OSA).
Study Design:
Retrospective claims-based analysis of OSA patients diagnosed with polysomnography (PSG) between January 1, 2005, and April 30, 2008.
Methods:
Patients 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.
Results:
Of 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.
Conclusions:
Among OSA patients in real-world practice, PAP users had significantly lower hospitalization risks and all-cause healthcare costs.
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