Longer PAP therapy for apnea reduces medical visits, costs

(HealthDay)—In patients with moderate-to-severe obstructive sleep apnea, positive airway pressure (PAP) therapy reduces acute and inpatient care visits as well as health care costs, according to a study recently published in the Journal of Clinical Sleep Medicine.

Douglas B. Kirsch, M.D., from Atrium Health in Charlotte, North Carolina, and colleagues performed a retrospective cohort study of 1,098 adult patients 18 years of age or older diagnosed with moderate-to-severe obstructive sleep apnea. Within this patient group, 60 percent were on PAP therapy for more than four hours a night for ≥70 percent of the studied nights. The average amount of PAP therapy received per night was 5.3 hours.

With every one-hour increase in PAP use per night, the researchers observed a 4 percent reduction in patient acute care clinical visits (rate ratio, 0.96; 95 percent confidence interval [CI], 0.92 to 0.99) and an 8 percent reduction in inpatient visits (rate ratio, 0.92; 95 percent CI, 0.86 to 0.98). When comparing adherent patients to less-adherent patients, the investigators noted fewer emergency department visits (rate ratio, 0.78; 95 percent CI, 0.62 to 0.98) and inpatient stays (rate ratio, 0.56; 95 percent CI, 0.35 to 0.91) among adherent patients. Increasing PAP usage was also tied to a lower likelihood of incurring positive health care costs from acute care visits (odds ratio, 0.94; 95 percent CI, 0.89 to 1.00) and inpatient care (odds ratio, 0.93; 95 percent CI, 0.86 to 1.00).

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