Sleep disorders and demand for medical services: evidence from a population-based longitudinal study

• Published in: PloS one Vol. 7; no. 2; p. e30085
• Main Authors: Santos-Silva, Rogerio, Castro, Laura Siqueira, Taddei, Jose Augusto, Tufik, Sergio, Bittencourt, Lia Rita Azeredo
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.02.2012; Public Library of Science (PLoS)
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Apnea; Blood pressure; Body mass; Body Mass Index; Body Weight; Correlation analysis; Diabetes; Disorders; Emergency medical services; Emergency Medical Services - statistics & numerical data; Emergency services; Epidemiology; Family medical history; Fatalities; Female; Health care expenditures; Health services; Hospitalization - statistics & numerical data; Humans; Hypertension; Inhabitants; Insomnia; Linear Models; Longitudinal Studies; Male; Medical diagnosis; Medical research; Medicine; Mental disorders; Middle Aged; Polysomnography; Population studies; Population-based studies; Prevalence; Primary care; Public Health; Regression models; Sex Characteristics; Sleep; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - physiopathology; Sleep disorders; Sleep Initiation and Maintenance Disorders - complications; Sleep Initiation and Maintenance Disorders - diagnosis; Sleep Initiation and Maintenance Disorders - physiopathology; Statistical analysis; Studies; Surveys; Womens health; Young Adult; Brazil
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0030085

The aim of this study was to investigate whether insomnia and obstructive sleep apnea (OSA) were predictors of hospitalizations or emergency department visits during two years following the Sao Paulo Epidemiologic Sleep Study (EPISONO) sample. All participants (n = 1,101) who underwent a baseline evaluation between July and December 2007 were contacted in December 2009 and asked to fill out a questionnaire about body weight changes, number of hospitalizations and visits to the emergency department. Participants lost during the follow-up period represented 3.2% (n = 35) and 7 subjects had died. Hospitalizations were reported by 116 volunteers (10.5%) and emergency department visits were reported by 136 participants (12.4%). The average body mass index (BMI) did not vary significantly between the first and the second assessment [26.7(95%CI:26.3-27.1) vs. 26.9(26.5-27.4) kg/m2]. After adjusting for confounders, a multiple logistic regression model revealed that female gender [1.4(1.0-1.9)], age ≥ 40 years, insomnia diagnosed according to the DSM-IV criteria [1.6(1.0-2.6)], and apnea-hypopnea index ≥ 15 [1.5(1.0-2.2)] were predictors of hospitalizations and/or demand for emergency services. Our study of a probabilistic sample of the Sao Paulo inhabitants shows that over a period of two years, insomnia and OSA were both associated with health impairment. Considering the high prevalence and public health burden of sleep disorders, the consequences of untreated disease for both the individual and society are undeniable and should be addressed.