The Costs Associated with Comorbid Sleep Conditions
Obstructive Sleep Apnea is a sleep-related disorder of growing prevalence in the United States. According to the American Sleep Apnea Association, of the 22 million Americans who have sleep apnea, 80 percent remain undiagnosed. This growing health crisis is further complicated by its severe comorbidities, which include heart disease, diabetes, and hypertension. The American Association of Sleep Medicine estimates that untreated sleep apnea costs $30 billion annually in increased healthcare utilization and medical costs associated with these comorbidities. Treating Obstructive Sleep Apnea not only improves health but also reduces the economic burden put on our healthcare system.
The connection between sleep apnea and its comorbidities becomes more apparent after examining the chain of events that occurs during an apnea episode. When the muscles around the throat relax, the airway then narrows, making breathing difficult. Oxygen levels in the blood drop and our bodies respond by releasing the stress hormone epinephrine, more commonly known as adrenaline. This “fight or flight” response elevates the heart rate and can lead to high blood pressure as the heart becomes less efficient at pumping blood. Our brain recognizes this inability to breathe and rouses us awake with gasps of breath so short that most OSA sufferers have no memory of them. Imagine this repeatedly happening throughout the night, and you can start to understand the strain that sleep apnea puts on the respiratory and cardiovascular systems.
In addition to being among the most serious medical conditions, sleep apnea’s comorbidities are among the most costly to treat. A study published in the World Journal of Otorhinolaryngology – Head and Neck Surgery examined the connection between sleep apnea and coronary heart disease. It revealed that men with OSA are six times more likely to be treated for congestive heart failure and are more likely to have fatal and nonfatal cardiovascular events if untreated. The study also found that both men and women with OSA have an increased risk of coronary heart disease. According to American Heart Association, the cost of heart disease from 2016 to 2017 in the U.S. was $219.6 billion. In the year 2013 alone, heart attacks and coronary heart disease were 2 of the 10 most expensive conditions treated in U.S. hospitals.
According to the American Diabetes Association journal Diabetes Spectrum, the lapses in breathing that occur during sleep apnea episodes create a build-up of sugar in the bloodstream. This build-up alters glucose metabolism and promotes insulin resistance, which is associated with the development of Type 2 diabetes, the most common form of the disease. The relationship between OSA and diabetes is reciprocal. The American Heart Association reports that 50% of people with diabetes have Obstructive Sleep Apnea, while 58% of older OSA patients have diabetes. For obese sleep apnea patients, the percentage grows to 86%. As with coronary heart disease, diabetes puts a massive financial burden on healthcare resources. In 2018 a study commissioned by The American Diabetes Association estimated the total costs of diagnosed diabetes in the U.S. had reached $327 billion, representing an increase of 26% over the previous five-year period.
As the sleep apnea crisis continues to grow in the U.S., so do its associated comorbidities. The positive news is that Continuous Positive Airway Pressure, or CPAP, is helping sleep apnea patients control their disease. Considered to be the gold standard in sleep apnea treatment, CPAP increases air pressure in the throat so that the airway does not collapse while breathing. Findings from a study published in the American Journal of Managed Care reported that patients using CPAP showed a reduced resting heart rate that carried over into the day. Resting heart rate is a strong predictor of adverse cardiovascular outcomes. CPAP has also been shown to help reduce blood sugar levels in patients with diabetes.
The health benefits of CPAP are well-researched, but the cost savings are also of significance. According to publication Healthcare Finance, for every one-hour of CPAP usage, there is an associated 8% decrease in hospital inpatient visits, a 4% decrease in acute care visits and overall less visits to the E.R. CPAP usage has been so successful that the American Academy of Sleep Medicine determined diagnosing and treating every patient in the U.S. with sleep apnea would produce an annual economic savings of $100.1 billion. CPAP therapy seems like an easy solution for both the health of OSA sufferers and the financial health of our nation. But sleep medicine has been poorly integrated into our healthcare system, resulting in a lack of a comprehensive solution that allows for transparency and alignment between patients and their medical team.
BetterNight has created a telehealth solution that works in collaboration with patients and their doctors, so communication is coordinated and seamless. With treatment plans taking as little as two weeks and affordably priced, BetterNight has compliance rates of 67%. By screening, diagnosing, and treating sleep apnea, BetterNight reduces the consequences from severe and often overlooked comorbidities. When we control chronic illnesses effectively, we are not only improving the health and wellbeing of the patient, but we are lifting the financial burden put on our healthcare system.
Interested in how BetterNight can improve the treatment of chronic conditions in your health system? Contact us today at sales@betternight.com