Sleep Apnea Rates Increased Substantially in the Last 25 Years

Tiina Mattila

While rates of sleep apnea has increased drastically since 1996, the overall cost to society has actually decreased in recent years.

A team, led by Tiina Mattila, Helsinki University Hospital, Department of Pulmonary Diseases, Meilahti Triangle Hospital, examined changes in the societal burden caused by sleep apnea between 1996-2018.

Public Health Threat

Sleep apnea has become more of a public health threat in recent years with the rise of obesity rates. However, from 2002-2010 Finland implemented a national sleep apnea program to increase awareness, improve diagnostics, and improve treatments.

In the study, the investigators identified national register data from the Care Register for Health Care, Statistics Finland, the Social Insurance Institution of Finland, and the Finnish Centre for Pensions to estimate disease prevalence, use of healthcare and social services, and societal costs.

Rates Increasing

The number of patients with sleep apnea increased in secondary care from 8600 in 1996 to 61,000 in 2018.

Coinciding with this increase was a continuous rise in outpatient visits in secondary care from 9700 in 1996 to 122,000 in 2018. The same trend was found in primary care visits, which increased from 10,000 in 2015 to 29,000 in 2018.

This increase also had an impact on businesses.

The cumulative annual number of days off work because of sleep apnea increased from 1100 to 46,000 throughout the study, but disability pensions for sleep apnea decreased from 820-550 during the observation period.

The overall societal costs per patients decreased by 50% during the observation period.

“The number of sleep apnea patients in Finland increased remarkably during the observation period. To control this burden, diagnostic methods and treatment were revised and follow up was reorganized,” the authors wrote. “Consequently, there was a significant decrease in societal costs per patient. The decrease in disability pensions suggests earlier diagnosis and improved treatment.”

However, with that said the investigators credited the national sleep apnea program as one of the initiatives that had improved overall outcomes.

Reducing the Risk

Earlier this year, investigators from China found the combined effects of multiple-dimensional lifestyle factors had an inverse effect on obstructive sleep apnea (OSA) risk.

Several risk factors have been associated with the condition, including being overweight, male, older age, and certain hereditary factors. Additionally, recent studies have shown that lifestyle factors such as aerobic physical activity, diet, smoking, and alcohol drinking were correlated with the occurrence and severity of OSA.

Investigators observed no passive smoking (OR, 0.83; 95% CI, 0.74–0.94), healthy waist-hip ratio (OR, 0.67; 95% CI, 0.58–0.77) and healthy mental status (OR, 0.45; 95% CI, 0.29–0.73) were associated with a reduced risk of OSA after adjusting for confounders.

Additionally, participants with a higher healthy lifestyle score were negatively associated with OSA risk (P < 0.001).

In comparison to the participants with 0–3 HLS, the odds ratio for participants with 4, 5, 6, and 7 HLS was 0.68 (95% CI, 0.56–0.84), 0.71 (95% CI, 0.59–0.86), 0.62 (95% CI, 0.51–0.76) and 0.49 (95% CI, 0.37–0.65) after adjusting for confounders.

The study, “Changes in the societal burden caused by sleep apnea in Finland from 1996 to 2018: A national registry study,” was published online in The Lancet Regional Health.