Sleep-disordered breathing comes at a heavy cost
In one of the largest studies of its kind Danish sleep researchers from the University of Copenhagen and the Danish Institute for Health Services Research have examined the socio-economic consequences of the sleep disorders snoring, sleep apnoea, and obesity-related respiratory difficulties (obesity hypoventilation syndrome (OHS)). These disorders are a serious health and social-economic burden on the individual and on society as a whole.
“Snoring, sleep apnoea, and obesity-related respiratory difficulties are fairly common disorders that affect a large proportion of the population,” according to Poul Jennum, Professor of Clinical Neurophysiology at the Center for Healthy Ageing at the University of Copenhagen Faculty of Health Sciences. He is head of the Danish Centre for Sleep Medicine, Glostrup Hospital, which treats patients from all over the country.
“Previous studies show that these disorders seriously affect quality of life, and our new studies show that people who snore violently, and particularly those who suffer from sleep apnoea, narcolepsy and obesity-related respiratory difficulties, are more frequently in contact with the health service than others; they take more medicine, they are unemployed more often and have lower average incomes than healthy people- The more serious their disorders, the greater the socio-economic costs.”
Patients with sleep apnoea or obesity-related respiratory difficulties incur medicine and hospital costs two to three times higher than healthy control subjects. The total health costs were twice as high, and unemployment was 30 per cent higher. Patients who suffered from obesity-related respiratory difficulties had the lowest rate of employment. When patients were in work they earned 30 per cent less than healthy control subjects, an indication of lower educational attainment and an effect of the health impact of their disorder.
Every violent snorer costs society €705; the figure for sleep apnoea is €3860, while obesity-related respiratory difficulties cost €11 320. These socio-economic consequences are present up to eight years before patients are finally diagnosed with sleep apnoea and obesity-related respiratory difficulties. The figures cover direct costs such as more frequent visits to the doctor, hospital admissions or medicine use, and indirect costs by way of lost labour, lower earnings and greater unemployment. The researchers also noted that the patients were more likely to be on welfare than healthy subjects, and more likely to be on prescription medicines subsidised by the state.
In addition to these costs there are also the actual costs of welfare payments. Patients who suffer from snoring, sleep apnoea or obesity-related respiratory difficulties received an average of €147, €879 and €3263 in extra welfare payments.
“Our study is the first to look at the actual socio-economic cost of the three disorders,” Professor Jennum continues. In the last couple of years he has conducted several studies into the socio-economic costs of sleep disorders such as narcolepsy, where researchers found higher medicine consumption, more hospital admissions, and 30 per cent greater unemployment when the disease was undiagnosed and untreated. So there is plenty of potential for ensuring earlier intervention, diagnosis and therapy.
“In the last few years we have become better at diagnosing and treating sleep apnoea and obesity-related respiratory difficulties. This may help our patients, because we know that there are lots and lots of people out there who are terribly tired in the daytime without being diagnosed and without knowing why. If you sleep badly at night for long periods at a time this may be due to various sleeping disorders, most of which we can treat nowadays. So it is important for people with sleep disorders to get in touch with the health service; otherwise their health, education, ability to work, and thereby their finances may be affected.”
The study was published on 2 January in Thorax: An international Journal Of Respiratory Medicine. http://thorax.bmj.com/content/early/2011/01/02/thx.2010.143958.short?rss=1
About the study
Sleep researchers examined data from 32 238 patients and 128 952 healthy subjects for an eight year period (1998 to 2006). The patients were selected from the Danish National Patient Registry and included men and women of all ages and all over the country.
The study was led by Poul Jennum, Professor of Clinical Neurophysiology at the Center for Healthy Ageing at the University of Copenhagen Faculty of Health Sciences and the Danish Centre for Sleep Medicine, Glostrup Hospital, and Jakob Kjellberg from the Danish Institute for Health Services Research.
Sleep apnoea is a condition characterised by the blockage of the upper airway and results in interrupted sleep and significant cardiovascular disorders. Obesity hypoventilation syndrome (OHS) is due to breathing difficulties in the severely overweight.