Prevention

As previously discussed in this chapter, a number of risk factors can predispose to, or exacerbate, OSAS. Targets for primary prevention are already integrated into many public health strategies, including campaigns focused on obesity, smoking and excessive alcohol consumption.

  UK Canada Spain Canada
Cost effectiveness# £1400 US$3354 €7861 >US$9792
AHI of patients events·h-1 >30 >15 41.3±14.6 67.6±24.3
ESS of patients 12   13.8±5.8  
Table 3 – Cost-effectiveness studies for continuous positive airway pressure treatment of obstructive sleep apnoea syndrome. Parameters are given as mean values ± standard deviation. AHI: apnoea/hypopnoea index; ESS: Epworth Sleepiness Scale. #: cost per quality-adjusted life year; : out of 24. Reproduced and modified from Mwenge and Rodendtein (in McNicholas and Bonsignore, 2010).

Prior to diagnosis, OSAS is associated with a large number of medical complaints and with annual healthcare costs per person of 50–100% more than those for the general population. In adults, these excess costs are attributable to cardiovascular disease, digestive problems and metabolic disease, while in children they are mainly due to ear, nose and throat (ENT) and respiratory conditions. Therefore, primary care physicians as well as physicians in a variety of specialties need to be aware of OSAS and sleep disordered breathing in order for the problem to be diagnosed and treated as promptly as possible. Secondary prevention therefore includes screening patients with the above conditions for symptoms potentially related to OSAS.

See the entire Sleep breathing disorders Chapter