ORIGINAL ARTICLE

Cardiovascular medication use in patients with undiagnosed obstructive sleep apnoea

K Otake¹, K Delaive¹, R Walld², J Manfreda³, M H Kryger¹

¹ Sleep Disorders Centre, St Boniface General Hospital Research Centre, Section of Respiratory Diseases and Department of Medicine, Winnipeg, Manitoba, Canada
² Centre for Health Policy and Evaluation, Winnipeg, Manitoba, Canada
³ Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

Correspondence to:
Correspondence to:
Dr M H Kryger, Sleep Disorders Centre, St Boniface General Hospital, 351 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada;
kryger{at}sleep.umanitoba.ca

Background: A study was undertaken in patients with undiagnosed sleep apnoea/hypopnoea syndrome (OSAS) to document the use of prescribed medications, especially those used in cardiovascular diseases, in the year before the OSAS diagnosis was confirmed.

Methods: A total of 549 patients with OSAS (401 men of mean age 47.2 years, mean body mass index (BMI) 35.5 kg/m², mean apnoea/hypopnoea index (AHI) 47.2 and148 women of mean age 50.2 years, BMI 39.6 kg/m², AHI 32.6) were each matched to one general population control by age, sex, geographical location, and family physician. Medication use was evaluated for patients and controls using a database containing information about all prescriptions completed in the province of Manitoba, Canada.

Results: In the year before OSAS was diagnosed, prescribed medication costs were $155.91 (Can) (95 % CI $91.34 to $220.49) greater for cases than for controls. Cases were dispensed 3.3 (95% CI 1.5 to 5.2) more prescriptions, were on 1.2 (95% CI 0.8 to 1.6) more medications, and were supplied with 157.4 (95% CI 95.9 to 218.8) more daily doses of medication. The odds ratio of OSAS cases being on a prescribed medication was 1.88 relative to controls (95% CI 1.38 to 2.54, p<0.0001). In the same year 36.6% of cases and 19.7% of controls were using medications for cardiovascular disease (OR 2.82, 95% CI 2.05 to 3.89, p<0.0001), consuming 79.4 (95% CI 48.9 to 109.8) more daily doses of medication, having been dispensed 1.7 (95% CI 1.0 to 2.4) more prescriptions, and at a $75.26 (95% CI $44.03 to $106.50) greater cost. The odds ratio of patients with OSAS being on medications indicated for the treatment of systemic hypertension was 2.71 (95% CI 1.96 to 3.77) relative to controls; however, such medications might also be prescribed for other indications such as angina pectoris and congestive heart failure, and for the secondary prevention of myocardial infarction. The use of medications indicated for the treatment of systemic hypertension was predicted significantly by age (odds ratio (OR) 1.10 per year), BMI (OR 1.05 per unit), and AHI (OR 1.01 per unit).

Conclusions: In the year before OSAS was diagnosed, patients with OSAS were heavy users of medications, particularly those used to treat cardiovascular diseases.

Keywords: obstructive sleep apnoea syndrome; cardiovascular medication

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Reuveni, H., Greenberg-Dotan, S., Simon-Tuval, T., Oksenberg, A., Tarasiuk, A. (2008). Elevated healthcare utilisation in young adult males with obstructive sleep apnoea. Eur Respir J 31: 273-279 [Abstract] [Full Text]  
• Krieger, J. (2007). Sleep apnoea and driving: how can this be dealt with?. ERR 16: 189-195 [Abstract] [Full Text]  
• Ayas, N. T., FitzGerald, J. M., Fleetham, J. A., White, D. P., Schulzer, M., Ryan, C. F., Ghaeli, R., Mercer, G. W., Cooper, P., Tan, M. C. Y., Marra, C. A. (2006). Cost-effectiveness of Continuous Positive Airway Pressure Therapy for Moderate to Severe Obstructive Sleep Apnea/Hypopnea.. Arch Intern Med 166: 977-984 [Abstract] [Full Text]  
• Insalaco, G., Romano, S., Marrone, O., Salvaggio, A., Bonsignore, G. (2005). A New Method of Negative Expiratory Pressure Test Analysis Detecting Upper Airway Flow Limitation To Reveal Obstructive Sleep Apnea. Chest 128: 2159-2165 [Abstract] [Full Text]  
• Tarasiuk, A., Greenberg-Dotan, S., Brin, Y. S., Simon, T., Tal, A., Reuveni, H. (2005). Determinants Affecting Health-Care Utilization in Obstructive Sleep Apnea Syndrome Patients. Chest 128: 1310-1314 [Abstract] [Full Text]  
• Ghiassi, R, Murphy, K, Partridge, M R (2004). Delays in diagnosis of OSAHS. Thorax 59: 540-540 [Full Text]  
• Tarasiuk, A., Simon, T., Tal, A., Reuveni, H. (2004). Adenotonsillectomy in Children With Obstructive Sleep Apnea Syndrome Reduces Health Care Utilization. Pediatrics 113: 351-356 [Abstract] [Full Text]  
• Pelletier-Fleury, N., Meslier, N., Gagnadoux, F., Person, C., Rakotonanahary, D., Ouksel, H., Fleury, B., Racineux, J-L. (2004). Economic arguments for the immediate management of moderate-to-severe obstructive sleep apnoea syndrome. Eur Respir J 23: 53-60 [Abstract] [Full Text]  
• W.T. McNicholas and J. Krieger on behalf of the Ta, , Members of the Task Force: W.T. McNicholas , P. Le, (2002). Public health and medicolegal implications of sleep apnoea. Eur Respir J 20: 1594-1609 [Full Text]  
• (2002). Poster presentations. Thorax 57: iii48-94 [Full Text]