Personal & Societal Consequences

The Takeaway

  • Obstructive sleep apnea can cause daytime sleepiness, snoring, depression, difficulties with concentration, and loss of memory.

The following symptoms of obstructive sleep apnea (OSA) can significantly reduce a person's quality of life. (In one study the reduction in quality of life with OSA was equivalent to that observed with diabetes or hypertension.1) However, treatment can successfully reduce and even resolve these problems.

Sleepiness

Many people with OSA are excessively sleepy during the daytime. This can make it difficult to work, and can even lead to job loss. If you have OSA you might fall asleep while driving a car, watching television, reading, talking on the telephone, or even while eating a meal. People with OSA might not complain of sleepiness; they just think that they are "slowing down" and getting more tired as they get older.

Depression and Memory Problems

Depression is very common in people with untreated OSA. Frequently, people are treated for depression for years before anyone realizes that OSA is causing the depression. People with OSA can also have memory problems, difficulty concentrating, amnesia of events, and slower reaction times.

Impact on Family and Friends

OSA can have a major impact on family and friends. Depression makes it hard to maintain relationships, and people with OSA are less likely to engage in social activities, especially physical exercise, because they are too tired. Because of the loud, bothersome snoring associated with OSA, spouses or bed partners might choose to sleep in separate bedrooms. For men, OSA can also lead to problems with impotence, although this can be the motivation for getting a physical evaluation.


Getting to the Doctor (1:03)
Dr. Geoffrey S. Gilmartin explains what leads people to seek treatment for obstructive sleep apnea.



Societal Consequences: Economic

At a societal level, economic and health utilization studies indicate that people with untreated OSA have greater rates of hospitalization and healthcare costs.2 It is estimated that the total economic cost of moderate to severe OSA is $65 to 165 billion annually in the United States (PDF).3 Successful treatment of OSA can reduce these rates and costs.4

Societal Consequences: Safety

People with OSA are up to ten times more likely to have a motor vehicle accident as a result of sleepiness, sometimes with fatal results.5 Persons who knowingly drive while sleepy may be at risk for civil and criminal liability.6 OSA-related sleepiness can be especially devastating with commercial truck drivers (who have higher rates of OSA) as well as operators of public transportation vehicles. A 2008 train crash in Boston was attributed to the sleepiness of a driver who likely had undiagnosed OSA.7 In this sad example, the driver was killed, passengers were injured, and millions of dollars of damages were incurred.8

References

  1. Baldwin CM, Griffith KA, Nieto FJ, O'Connor GT, Walsleben JA, Redline S. The association of sleep-disordered breathing and sleep symptoms with quality of life in the sleep heart health study. Sleep 2001;24:96-105.
  2. AlGhanim N, Comondore VR, Fleetham J, Marra CA, Ayas NT. The economic impact of obstructive sleep apnea. Lung 2008;186:7-12.
  3. Harvard Medical School Division of Sleep Medicine. The price of fatigue. December, 2010. http://sleep.med.harvard.edu/what-we-do/public-policy-research
  4. Peker Y, Hedner J, Johansson A, Bende M. Reduced hospitalization with cardiovascular and pulmonary disease in obstructive sleep apnea patients on nasal CPAP treatment. Sleep 1997; 8:645-53.
  5. George CF. Sleep apnea, alertness, and motor vehicle crashes. Am J Respir Crit Care Med 2007;176:954-6.
  6. Madigan E. New Jersey cracks down on drowsy driving. Stateline, November 18, 2003. http://www.stateline.org/live/ViewPage.action?siteNodeId=136&languageId=1&contentId=15476
  7. Czeisler CA. Drowsy-driving tragedies preventable. Boston Globe, August 3, 2009. http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/08/03/drowsy_driving_tragedies_preventable/
  8. Chakrabarti M. NTSB faults T safety systems in deadly T crash. WBUR, July 15, 2009. http://www.wbur.org/2009/07/15/mbta-crash-report

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This content was last reviewed on February 11, 2011