SLEEP · 2004 · 507 citations · 30 references
MedicinePharmacoeconomicsCost-effectiveness AnalysisCost-utility AnalysisSleep MedicineAirway ManagementContinuous Positive Airway PressureSleep Apnea CareSleep HealthSleep-disordered BreathingSleep-related Breathing DisordersApnea-hypopnea Index ReductionCollision RiskMulti-way Sensitivity AnalysisNasal Continuous Positive Airway PressureObstructive Sleep Apnea TherapyObstructive Sleep Apnea TreatmentOne-way Sensitivity AnalysisSleep Apnea Syndrome
STUDY OBJECTIVES: Drivers suffering from obstructive sleep apnea syndrome (OSAS) have an increased risk for being involved in motor-vehicle collisions. This study estimates, for the first time, the annual OSAS-related collisions, costs, and fatalities in the United States and performs a cost-benefit analysis of treating drivers suffering from OSAS with continuous positive airway pressure (CPAP). DESIGN: The MEDLINE-PubMed database (1980 to 2003) was searched for information on OSAS. A meta-analysis was performed of studies investigating the relationship between collisions and OSAS. Data from the National Safety Council were used to estimate OSAS-related collisions, costs, and fatalities and their reduction with treatment. Next, the annual cost of treating OSAS with CPAP was calculated. Finally, multiple 1-way sensitivity analyses were performed. SETTING: N/A. PATIENTS OR PARTICIPANTS: N/A. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: More than 800,000 drivers were involved in OSAS-related motor-vehicle collisions in the year 2000. These collisions cost 15.9 billion dollars and 1,400 lives in the year 2000. In the United States, treating all drivers suffering from OSAS with CPAP would cost 3.18 billion dollars, save 11.1 billion dollars in collision costs, and save 980 lives annually. CONCLUSION: Annually, a small but significant portion of motor-vehicle collisions, costs, and deaths are related to OSAS. With CPAP treatment, most of these collisions, costs, and deaths can be prevented. Treatment of OSAS benefits both the patient and the public.
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