1083 Association Between Sleep Apnea and Health Service Utilization: Results from the Health and Retirement Study

Sleep apnea is associated with several health conditions known to increase the use of health services that may otherwise be preventable (e.g., hospitalization). We investigated the association of sleep apnea and the subsequent use of health services, independent of health conditions and other potential confounders.

We studied participants aged 50+ years in the 2016 and 2018 Health and Retirement Study (HRS), a nationally representative cohort of approximately 20,000 middle-aged and older adults in the United States. In 2016, participants were asked if “a doctor had ever told them they have a sleep disorder,” and if so, which disorder (which included sleep apnea). We categorized participants as with and without sleep apnea. In 2018, participants were asked to report on their use of health services, including hospitalization, home healthcare, and nursing home use. We used logistic regression to determine the association between sleep apnea, as reported in 2016, and the use of health services in 2018, after adjusting for demographics, BMI, health conditions, and depressive symptoms.

We studied N=20,115 HRS participants, of whom 11.8% reported sleep apnea. Compared to those without sleep apnea in 2016, those with sleep apnea had a 21% higher odds of reporting future use of any health service (Adjusted Odds Ratio [AOR]=1.21, 95% Confidence Interval [CI]=1.02-1.43), after controlling for confounders. Specifically, those with sleep apnea had greater odds of hospitalization (AOR=1.21, 95% CI=1.02-1.44), and while not statistically significant, home healthcare services (AOR=1.23, 95% CI=0.99-1.54).

Participants with sleep apnea had increased odds for future health service utilization, including hospitalization and home healthcare. Findings highlight the importance of addressing sleep apnea to reduce their burden on the healthcare system.

This study was supported by the National Institute on Aging (R01AG079391, K01AG061239, P30AG028740) and the Sleep Research Society Foundation (23-FRA-001).