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. 2022 Feb 28:16:100338.
doi: 10.1016/j.lanepe.2022.100338. eCollection 2022 May.

Changes in the societal burden caused by sleep apnoea in Finland from 1996 to 2018: A national registry study

Tiina Mattila  1   2 , Hannele Hasala  3 , Hanna-Riikka Kreivi  1 , Heidi Avellan-Hietanen  1 , Adel Bachour  1 , Fredrik Herse  4 , Riikka-Leena Leskelä  4 , Sanna Toppila-Salmi  5   6 , Marina Erhola  7 , Tari Haahtela  5   6 , Tuula Vasankari  8   9
Affiliations

Changes in the societal burden caused by sleep apnoea in Finland from 1996 to 2018: A national registry study

Tiina Mattila et al. Lancet Reg Health Eur. .

Abstract

Background: In the current century, sleep apnoea has become a significant public health problem due to the obesity epidemic. To increase awareness, improve diagnostics, and improve treatment, Finland implemented a national sleep apnoea programme from 2002 to 2010. Here, we present changes in the societal burden caused by sleep apnoea from 1996 to 2018.

Methods: National register data were collected from the Care Register for Health Care, Statistics Finland, the Social Insurance Institution of Finland, and the Finnish Centre for Pensions. Disease prevalence, use of healthcare and social services, and societal costs were estimated.

Findings: The number of sleep apnoea patients increased in secondary care from 8 600 in 1996 to 61 000 in 2018. There was a continuous increase in outpatient visits in secondary care from 9 700 in 1996 to 122 000 in 2018 (1 160%) and in primary care from 10 000 in 2015 to 29 000 in 2018 (190%). Accordingly, the cumulative annual number of days off work for sleep apnoea increased from 1 100 to 46 000. However, disability pensions for sleep apnoea decreased from 820 to 550 (33%) during the observation period. Societal costs per patient decreased over 50% during the observation period (€2 800 to €1 200).

Interpretation: The number of sleep apnoea patients in Finland increased remarkably during the observation period. To control this burden, diagnostic methods and treatment were revised and follow up was reorganised. Consequently, there was a significant decrease in societal costs per patient. The decrease in disability pensions suggests earlier diagnosis and improved treatment. The national sleep apnoea programme was one of the initiators for these improved outcomes.

Funding: The Finnish Institute for Health and Welfare and the Hospital District of Helsinki and Uusimaa (HUH), Helsinki, Finland.

Keywords: Obesity; Public health; Respiratory programme; Sleep apnoea.

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Conflict of interest statement

The corresponding author Tiina Mattila performed this study with financial support from the Hospital District of Helsinki and Uusimaa. All other co-authors conducted the work related to this study as part of their regular duties. Sanna Toppila-Salmi has got grants (GSK) and consultancy fees (ALK Abello, AstraZeneca, ERT, Novartis, Sanofi Pharma, Roche Products) outside of this work. Tari Haahtela has got lecture fees (GSK, Mundipharma, Orion Pharma, Sanofi) outside of this work. The corresponding author and the other authors do not have any relevant conflicts of interest.

Figures

Fig 1
Figure 1
The total number of sleep apnoea patients, outpatient visits in primary and secondary care, hospital (inpatient) days in secondary and primary care, sick-leave days, and disability pensions during the observation period (1996 to 2018).
Fig 2
Figure 2
Change in the burden of sleep apnoea from 2010 to 2019 in the outpatient clinics of respiratory diseases in TAYS and HUH and number of initiated new CPAP treatments in TAYS, Helsinki, and Hyvinkää. All numbers are per 100 000 inhabitants.
Fig 3
Figure 3
a-b. a) Total direct healthcare and indirect disability/lost productivity costs for sleep apnoea during the 23-year period from 1996 to 2018. b) Per patient costs.
Picture 1
Picture 1
A map of Finland and the districts of Tampere University Hospital (TAYS) and Helsinki University Hospital (HUH).
See this image and copyright information in PMC

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