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Dose-Response Relationship between Obstructive Sleep Apnea Therapy Adherence and Healthcare Utilization
Atul Malhotra1, Kimberly L Sterling2, Peter A Cistulli3
1University of California, San Diego, La Jolla, California.
Annals of the American Thoracic Society
|February 3, 2023
Summary
Positive airway pressure (PAP) therapy for obstructive sleep apnea shows a dose-response benefit. Even minimal nightly use of 1-3 hours significantly reduces hospitalizations and ER visits, improving healthcare outcomes.
Area of Science:
- Sleep Medicine
- Health Services Research
Background:
- Optimal positive airway pressure (PAP) therapy usage for obstructive sleep apnea (OSA) lacks clear definition due to limited data on usage hours and clinical outcomes.
- Understanding the dose-response relationship is crucial for effective OSA management.
Purpose of the Study:
- To investigate the dose-response relationship between PAP usage and healthcare resource utilization in OSA patients.
- To determine the minimum device usage necessary to achieve clinical benefits.
Main Methods:
- Utilized a linked dataset combining administrative claims from over 100 U.S. health plans with individual patient PAP usage data.
- Analyzed data from 179,188 adult patients diagnosed with OSA between June 2014 and April 2018, with at least one year pre- and two years post-therapy initiation.
- Healthcare resource utilization, including hospitalizations and emergency room visits, was assessed at 3, 12, and 24 months post-PAP initiation.
Main Results:
- A clear dose-response relationship was observed between daily PAP usage and healthcare utilization.
- Minimum device usage required for benefit was found to be 1-3 hours per night.
- Increasing PAP usage demonstrated statistically significant reductions in hospitalizations (5-10% per additional hour) and emergency room visits (5-7% per additional hour) at all time points.
Conclusions:
- Compelling evidence supports a dose-response relationship between PAP usage and reduced healthcare utilization in OSA patients.
- Clinical benefits, including decreased hospitalizations and ER visits, are evident even with low usage levels of 1-2 hours per night.
Keywords:
OSAdose–responseemergency room visitshealthcare resource utilizationhospitalizationpositive airway pressureMore Related Videos
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