Healthcare Use in Individuals with Obesity and Chronic Hypoxemia Treated for Sleep Disordered Breathing

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
Marcus PovitzMatthew T James

Abstract

To determine if treatment of obstructive sleep apnea (OSA) and obesity hypoventilation syndrome (OHS) among patients with chronic hypoxemia is associated with reduced healthcare utilization. We performed a retrospective cohort study of 129 obese, hypoxemic patients who underwent polysomnography and were prescribed positive airway pressure (PAP) therapy. During a 2-year follow-up period we examined the associations between adherence to PAP therapy and rates of hospitalization, emergency room (ER) visits, and outpatient visits. Severe OSA and OHS were common, as were hypertension, cardiovascular, and pulmonary disease. Forty-nine percent of patients were adherent with PAP therapy. Compared to patients who were not adherent to PAP therapy, adherent patients had significantly lower rates of all-cause hospitalization (incident rate ratio [IRR]:0.55, 95% CI 0.33, 0.93) after adjustment for age, sex and hospitalisation rates prior to treatment. Adjustment for additional comorbidities attenuated this association (IRR: 0.61, 95% CI 0.35, 1.06). Adherence with PAP therapy was associated with lower odds of frequent hospitalization (odds ratio 0.23, 95% CI 0.07, 0.73). There were no significant differences in the rates of ER or outpatient ...Continue Reading

Citations

Aug 23, 2019·Annals of the American Thoracic Society·Sachin R PendharkarPatrick J Hanly

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