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University of Maryland School of Medicine Research Shows That Older Patients With Untreated Sleep Apnea Need Greater Medical Care

January 16, 2020 | Joanne Morrison

Emerson M. Wickwire, PhD

Older Patients with Untreated Sleep Apnea Cost Nearly $20,000 More a Year and Saw More Hospitalizations, New Research Shows

Obstructive sleep apnea (OSA) is a common and costly medical condition leading to a wide range of health risks such as cardiovascular disease, stroke, depression, diabetes and even premature death. Researchers at the University of Maryland School of Medicine (UMSOM) found that the medical costs are substantially higher among older adults who go untreated for the disorder.

The research, which was published in the Journal of Clinical Sleep Medicine, involved a review of a national sample of Medicare claims data. The researchers measured the health care costs over a year among Medicare beneficiaries who were 65 years and older and were ultimately diagnosed with OSA. They found that patients who went undiagnosed with OSA over a 12-month period had more doctor’s appointments, emergency room visits, and hospital stays prior to being treated for the disorder. These patients on average had nearly $20,000 more in costs a year than those who were diagnosed and treated for OSA, the research found.

“Sleep disorders represent a massive economic burden on the U.S. health care system,” said Emerson Wickwire, PhD, Associate Professor of Psychiatry and Medicine at UMSOM and Director of the Insomnia Program at the University of Maryland Medical Center, Midtown Campus. Dr. Wickwire, who was the Principal Investigator for this research, explained that economic aspects of diseases are increasingly recognized as important drivers of health decisions by patients, those paying for services, policymakers and ultimately the taxpayers.

Medical costs among those untreated for OSA will continue to rise, he warned, highlighting the importance of early detection and treatment among older adults.

“We conducted the largest economic analysis of sleep apnea among older adults to date,” said Dr. Wickwire. “Medicare beneficiaries with obstructive sleep apnea cost taxpayers an additional $19,566 per year and utilized more outpatient, emergency, inpatient, prescription, and overall health care services. It's important to realize that costs associated with untreated sleep disorders are likely to continue to accrue year after year, which is why our group focuses on early recognition and treatment."

Researchers also observed that Medicare patients with OSA were more likely to suffer from other ailments more so than those individuals without the sleep disorder. For example, OSA is linked to an increased risk for high blood pressure, diabetes, heart disease, stroke and depression. The study authors suggest that insurers, legislators, and health systems leaders consider routine screening for OSA in older patients, especially those with medical and psychiatric comorbidities, to better contain treatment costs.

“The good news is that highly effective diagnostic and treatment strategies are available. Our team is currently using big data approaches as well as highly personalized sleep disorders treatments to improve outcomes and reduce costs associated with sleep disorders, "said Dr. Wickwire.

The research is critical as OSA affects up to 70% of elderly nursing home residents, and these individuals are at higher risk of death.

A 2016 report by the American Academy of Sleep Medicine estimated that undiagnosed OSA among U.S. adults costs $149.6 billion annually. While the report projected it would cost the health care system nearly $50 billion to diagnosis and treat every American adult with OSA, treatment would produce savings of $100 billion. The current study in JCSM led by Dr. Wickwire is the largest analysis to date of the economic burden of untreated OSA among older adult Medicare beneficiaries.

“Early detection and treatment for disorders such as obstructive sleep apnea is critical, particularly among older adults who face the risk of the most serious illnesses such as cardiovascular disease, hypertension, stroke, and diabetes,” said UMSOM Dean E. Albert Reece, MD, PhD, MBA, who is also Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor, University of Maryland School of Medicine.

About the University of Maryland School of Medicine

Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world -- with 45 academic departments, centers, institutes, and programs; and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished two-time winner of the Albert E. Lasker Award in Medical Research.  With an operating budget of more than $1.2 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic and clinically based care for nearly 2 million patients each year. The School of Medicine has more than $540 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total population of nearly 9,000 faculty and staff, including 2,500 student trainees, residents, and fellows. The combined School of Medicine and Medical System (“University of Maryland Medicine”) has an annual budget of nearly $6 billion and an economic impact more than $15 billion on the state and local community. The School of Medicine faculty, which ranks as the 8th highest among public medical schools in research productivity, is an innovator in translational medicine, with 600 active patents and 24 start-up companies. The School of Medicine works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit

About the Sleep Disorders Center at the University of Maryland Medical Center, Midtown Campus

The Sleep Disorders Center at University of Maryland Medical Center Midtown Campus conducts overnight and daytime sleep studies. Among the common sleep disorders treated at the center are sleep apnea, restless legs syndrome, nocturnal behavioral problems and insomnia.


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Joanne Morrison
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