People who are prone to snoring or suffer from other breathing difficulties during sleep can have a hard time sleeping. This disturbed sleep not only affects their health, but also influences their social interaction with others and efficiency at work. This is reflected in poor employment and less earning. There are various direct and indirect medical costs too. A recent study performed in Copenhagen, Denmark, conclusively pointed out these facts, which had not been studied properly so far.
Snoring, sleep apnea (SA) and disrupted breathing due to obesity (obesity hypoventilation syndrome or OHS) are disorders that affect breathing during sleep. These disorders speed up the development of diseases like heart attack and stroke and increase the risk of death due to them. People suffering from sleep disorders are likely to be compromised in the social context and quality of life, employment status and ability to work. The economic burden from sleep-related breathing disorders is difficult to calculate. However, in Denmark, data of all patients attending private and government clinics is recorded in the National Patient Registry. This study used these records to determine the socio-economic consequences of snoring and related disorders.
- Records of 12,045 people diagnosed with snoring, 19,438 patients of sleep apnea and 755 patients with OHS were obtained and matched with control groups of 48,180, 77,752 and 3,020 individuals respectively.
- Annual cost of illness per patient diagnosed with snoring and related disorders was calculated and compared in matched control groups.
- The cost was divided into annual direct and indirect health care costs. Outpatient clinic costs, hospital costs, primary care costs and drug costs were included in direct costs, while loss of labor market was included in indirect cost.
- Annually, patients who snored spent $958, those with sleep apnea spent $5,243, and those with OHS spent $15,354 more than their respective control groups.
- Patients with sleep apnea and OHS had lower income, irrespective of age; it was more so if they were women.
- There was no difference in risk related to death among snorers and matched controls, whereas it was higher (6.1 percent) in patients with sleep apnea as compared to controls (4.4 percent); and it was even higher (25.4 percent) in people with OHS, as compared to the control group (6.8 percent).
- Employment rates were lower by 30 percent in patients, as compared to controls. Even if employed, the patients suffering from snoring and sleep-related breathing disorders earned less than control groups.
One of the limitations of this study is that the precision of detecting and treating sleep-related disorders depends on the tools available to doctors and might differ from one doctor to another. Other shortcomings are that newer treatments like “continuous positive airway pressure” may have been underreported, and that, in this study, the authors have not described the treatment of sleep related disorders with this treatment in detail.
People who suffer from sleep related breathing disorders, like snoring, experience not only health issues, but also an economic burden related to diagnosis and treatment of their disorders. They also have lower employment rates and earn less income. These findings are more severe in overweight people with OHS. Such people also have a higher risk of death. Early diagnosis and management are key factors that would help improve this situation. The researchers state that, “Appropriate diagnostic facilities and treatment must be provided to improve quality of life and to decrease the risk of secondary complications … and the negative influence on employment.”
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Publication Journal: Thorax, January 2011
By Poul Jennum; Jakob Kjellberg; Danish Center for Sleep Medicine, University of Copenhagen, Denmark, and the Danish Institute for Health Services Research, Copenhagen, Denmark