FAIR Health Study Delves into Sleep Apnea

March 15, 2018

FAIR Health data analysis has revealed compelling findings about sleep apnea, a potentially serious disorder in which an individual repeatedly stops and starts breathing during sleep. Nationally, private insurance claim lines with a diagnosis of sleep apnea grew 850 percent from 2014 to 2017, FAIR Health found.

Sleep apnea claim lines grew in both rural and urban areas during that period, but more so in rural areas, where the increase was 911 percent. In urban settings, the increase was 839 percent.

Rural diagnoses of sleep apnea grew from 0.2 percent of all rural medical claim lines to 1.98 percent. In urban settings, the increase was from 0.13 percent of all urban medical claim lines to 1.24 percent, and in the nation overall, from 0.14 percent of all national medical claim lines to 1.33 percent.

Other FAIR Health findings concerned gender and age. In the period 2016-2017, males accounted for 65 percent of sleep apnea claim lines, females 35 percent. The age group 51 to 60 years accounted for 31 percent of sleep apnea claim lines—the largest share of eight age groups studied. Patients 61 to 70 years old were second, representing 23 percent of claim lines, and those 41 to 50 years old were third, constituting 20 percent.

Also in 2016-2017, the most common diagnoses associated with sleep apnea on claim lines were diabetes, hypertension, respiratory and chest symptoms, dorsalgia (back pain), high cholesterol, general fatigue, joint pain and cardiac dysrhythmias (abnormal heartbeats). The three most common (and costly) devices associated with sleep apnea diagnoses were (ranked from most to least common and costly): continuous positive airway pressure (CPAP) devices, disposable filters used with positive airway pressure devices and headgear used with positive airway pressure devices.

In 2017, the states with the most sleep apnea claim lines as a percent of all medical claim lines by state were (ranked from most to least) Maryland, Idaho, Utah, Arkansas and Iowa. The states with the lowest proportion of sleep apnea claim lines were (from least to most) New Hampshire, Minnesota, Massachusetts, Vermont and Hawaii.

FAIR Health’s research on sleep apnea was based on data from its repository of over 25 billion privately billed claim records.

“Sleep apnea is a public health issue of increasing interest and concern,” said FAIR Health President Robin Gelburd. “FAIR Health is ready to contribute its data resources and analytical capabilities to help researchers, policy makers and others delve more deeply into this issue.”

For an infographic on FAIR Health’s sleep apnea study, click here.