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The Cost of Untreated and Undiagnosed Sleep Apnea
Over 22 million Americans suffer from sleep apnea or related breathing disorders, and yet close to 80% of them remain undiagnosed despite considerable efforts by public education campaigns and increased media attention on what some professionals are calling an epidemic. And for those diagnosed with sleep apnea, noncompliance with recommended treatments remains over 50%. Studies are finding more and more long-term effects of untreated sleep apnea as the CPAP and BiPAP industries struggle to save lives by making their products more accomodating, effective, and affordable.
So how can we convince those with sleep apnea symptoms to get tested? And how can we more effectively incentivize compliance? The following is a list of the potential long-term consequences of untreated apnea. For the purpose of educating the public, we hope that readers share this information to anyone affected by the disorder, or to anyone interested in promoting a higher quality of life for millions of people all over the world.
Lack of sleep is only the beginning. It is now common knowledge that sleep apnea, whether OSA (obstructive sleep apnea), CSA (central sleep apnea), or Mixed apneas with characteristics of both, can be linked to serious health risks such as diabetes, hypertension or high blood pressure, heart disease, coronary artery disease, obesity, and stroke. A guideline for healthcare professionals from the American Heart Association reported in 2010 that 65% of stroke patients had some form of debilitated breathing such as nocturnal hypoventilation, anxiety related shallow breathing, or Cheyne–Stokes respiration (CSR), the vast majority of them diagnosed with sleep apnea. It seems that now more than ever, Americans are having trouble breathing and suffering as a result.
In regard to cognitive issues, sleep apnea is now linked to memory loss, absentmindedness, and may even be a precursor to alzheimer’s disease. More commonly attributed to adults, sleep apnea also affects children and infants, and may be linked to Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD), as well as behavior problems and mood disorders associated with sleep interruptions. The website Soclean reports that roughly 4% of children are currently dealing with undiagnosed or misdiagnosed sleep apnea, many of them suffering from headaches, fatigue, and learning disabilities that are often dismissed at growing pains or temporary ailments.
Energy and Metabolism
Sleep apnea reduces the amount of oxygen in the blood, which can impair the function of internal organs and exacerbate any health conditions that already exist. This vicious cycle of debilitation tends to manifest itself in further symptoms as the condition progresses, leaving patients with lowered energy, weakened metabolisms, and slowly failing organ systems. Since sleep apnea disrupts circadian rhythms and prevents deep states of sleep, there are major disruptions to the chemical processes of the body and mind, even slowing down or preventing the detoxification of brain tissue as the glymphatic system remains stagnant in the absence of deep sleep stages.
According to a factsheet distributed by the company ResMed, one of the most successful sleep apnea therapy device manufacturers in the world, over 42 Americans have some form of sleep disordered breathing, 1 in 5 adults has mild OSA, 1 in 15 has moderate to severe OSA, and 9% of middle-aged women and 25% of middle-aged men have some form of sleep apnea. Overall, the amount of affected Americans is similar to that of asthma (20+ million) and diabetes (23+ million), both of which have been addressed by massive public health campaigns that still struggle to reach all those who suffer from the effects of limited treatment.
The Economic Cost
A 2016 report by Frost and Sullivan Researchers found that the annual economic burden of undiagnosed sleep apnea among U.S. adults is approximately $149.6 billion. This includes $86.9 billion in lost productivity, $26.2 billion in motor vehicle accidents, $6.5 billion in workplace accidents, and an additional $30 billion annually in increased healthcare and medication costs related to the advancement of diseases related to unchecked apneas.
At the same time, ResMed’s current statistics account for $200,000 more in healthcare costs during the two-year period prior to diagnosis. This means that prior to a sleep apnea diagnosis, patients used roughly 25–50% more medical resources than the two years after the diagnosis. This brings the total economic burden of additional medical costs from undiagnosed sleep apnea to over $50 billion in one country alone. And in regard to traffic accidents, they estimate “treating all US drivers currently suffering from sleep apnea would save $11.1 billion in collision costs and save 980 lives annually.” While some regard statistics like these as merely number, without a face or a story. But the faces are around us every day of our lives. And the story is a simple one: Do your part today to identify and treat this disorder. You or a loved one may lose a few hours to a sleep clinic, but you would gain an understanding that could very well improve your health, give you restful sleep you may not have experienced in years, and save you and the economy thousands of dollars over the remaining years of your life. In fact, you may even be saving someone’s life.
American Academy of Sleep Medicine – https://aasm.org/economic-burden-of-undiagnosed-sleep-apnea-in-u-s-is-nearly-150b-per-year/
American Journal of Respiratory and Critical Care Medicine – https://www.ncbi.nlm.nih.gov/pubmed/10712333?dopt=Abstract
Frost and Sullivan – https://aasm.org/resources/pdf/sleep-apnea-economic-crisis.pdf
Journal of Clinical Sleep Medicine – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556913/
Journal of Thracic Disease – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906370/
Sleepapnea.org – https://www.sleepapnea.org/learn/sleep-apnea/