Increasing sleep apnoea burden in the elderly in Finland from 1996 to 2018: A national registry study

Abstract

Background: In many countries, obstructive sleep apnoea is causing an increased burden on healthcare. In Finland (population 5,5 million), the diagnoses of the condition have raised 7-fold from 1996 to 2018. Here, we present register-based data on sleep apnoea in the elderly Finnish people (aged ≥ 60 years) during the 23-year period. Methods: Two cohorts were explored. The first cohort included all Finns who used public health services during the 23-year period. The data was collected from the Register for Health Care, Statistics Finland. The second cohort consisted of patients treated in the respiratory outpatient clinics from 2010 to 2019 in Tampere and Helsinki University Hospitals with a population of about 1,3 million. Results: In people aged 60–69 years, the diagnoses of sleep apnoea per 100 000 persons have increased 9-fold, from 0.26 % (1996) to 2.3 % (2018). In those aged ≥ 70 years, the increase has been 23-fold, from 0.06 % to 1.4 %. Obesity is a growing risk factor. During the follow up, the direct healthcare costs of sleep apnoea increased from about €1 million (1996) to nearly €16 million (2018). The cost increase was explained by the mounting outpatient care costs with CPAP-treatment (Continuous Positive Airway Pressure). Conclusions: In Finland, the prevalence and costs of diagnosed sleep apnoea and CPAP treatment have been in alarming increase in the elderly. This reflects improved awareness and diagnostics, but a risk of over diagnostics and over treatment is obvious. CPAP-treatment must be better targeted to those in true need.