The costs of sleep related breathing disorders: a prospective, representative study in the German state of Hessen

Introduction The aim of this analysis was to obtain the indirect and direct cost of sleep related breathing disorders (srbd) and to identify relevant other cost factors. Materials and methods The study was performed in a total of 627 srbd patients ( f  = 124 und m  = 503) recruited by 18 sleep centers in the German state of Hessen. Baseline investigation comprised a detailed clinical investigation with a retrospective questionnaire for the last three months on the demographic and socio-economic situation, and the course of the disease (duration, severity of symptoms, time of diagnosis, daytime sleepiness, depression, quality of life, responsible physician etc.). Direct costs were drawn from the reported consumption of resources, the indirect costs were drawn according to the human capital method. The costs were obtained from the societal, the caretaker and the patient’s perspective. Results Patients had a mean age of 56,1 years, 80.1% were married, 37.0% had a high school diploma and 26.5% a secondary school diploma. 12.7% of all patients reported disease related changes of their professional situation (among others 12.8 days of absence in the study period/per patient). At the time of the study patients had undergone medical treatment for a mean of 8,3 months. 31.7% had been treated by general physicians, 6.1% by neurologists, and 45.8% by other physicians (interns, pulmonologists etc.). A large part of the total costs was caused by the indirect costs (mean of 422±1745€). During the study period the mean costs for ambulatory consultations was 54±61€. About 21% of all patient were treated in a hospital setting, causing mean costs of 249±537€ per patient. The influence of the severity of the disease and it‘s duration, daytime sleepiness, BMI and depression on the variance of the total costs and of direct costs was studied by multivariate analyses. Conclusion Srbd can cause a high financial burden for the health system as well as for the single patient. The subjective burden for the patient is reflected by a relevant reduction of quality of life (EQ 5D 0.86±0.19 und EQ VAS 66.8±19.3). Acknowledgements This study was commissioned and financed by the German Sleep Society DGSM.