ArticleSleep2011
An integrated health-economic analysis of diagnostic and therapeutic strategies in the treatment of moderate-to-severe obstructive sleep apnea.
Article in Sleep, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
71 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Home-testing devices for diagnosing obstructive sleep apnoea hypopnoea syndrome - a systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2026Pooled it
- Content Comparison of Quality-of-Life Instruments Used in Economic Evaluations of Sleep Disorder Interventions: A Systematic Review.PharmacoEconomics · 2024Pooled it
- Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019Pooled it
- Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2017Guideline
- An Economic Evaluation of Home Versus Laboratory-Based Diagnosis of Obstructive Sleep Apnea.Sleep · 2015Trial
- Trial
- Home-based diagnosis of obstructive sleep apnea in an urban population.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2014Trial
- Diagnosis of obstructive sleep apnea using pulse oximeter derived photoplethysmographic signals.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2014Trial
- Trial
- Obstructive sleep apnea is a predictor of abnormal glucose metabolism in chronically sleep deprived obese adults.PloS one · 2013Trial
- Trial
- Redefining Obstructive Sleep Apnea: Treatment in the Modern Era.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026Review
- Failure to complete diagnostic testing in patients with suspected obstructive sleep apnoea and inconclusive home sleep apnoea test.Sleep & breathing = Schlaf & Atmung · 2025Article
- Cost-utility analysis of a tiered diagnostic approach combining a screening model and polysomnography in pediatric obstructive sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Sleep-disordered breathing diagnosis: a comprehensive audit of home sleep testing in real clinical settings.Sleep & breathing = Schlaf & Atmung · 2024Article
- Recent advances in managing obstructive sleep apnea.World journal of clinical cases · 2024Article
- The OSA patient journey: pathways for diagnosis and treatment among commercially insured individuals in the United States.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- International Consensus Statement on Obstructive Sleep Apnea.International forum of allergy & rhinology · 2023Review
- Cost-effectiveness of neuromuscular electrical stimulation for the treatment of mild obstructive sleep apnea: an exploratory analysis.International journal of technology assessment in health care · 2023Article
- Moving toward Equitable Care for Sleep Apnea in the United States: Positive Airway Pressure Adherence Thresholds: An Official American Thoracic Society Policy Statement.American journal of respiratory and critical care medicine · 2023Article
11 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesObstructive sleep apnea (OSA) is a common disorder associated with substantially increased cardiovascular risks, reduced quality of life, and increased risk of motor vehicle collisions due to daytime sleepiness. This study evaluates the cost-effectiveness of three commonly used diagnostic strategies (full-night polysomnography, split-night polysomnography, unattended portable home-monitoring) in conjunction with continuous positive airway pressure (CPAP) therapy in patients with moderate-to-severe OSA.
designA Markov model was created to compare costs and effectiveness of different diagnostic and therapeutic strategies over a 10-year interval and the expected lifetime of the patient. The primary measure of cost-effectiveness was incremental cost per quality-adjusted life year (QALY) gained. PATIENTS OR
participantsBaseline computations were performed for a hypothetical average cohort of 50-year-old males with a 50% pretest probability of having moderate-to-severe OSA (apnea-hypopnea index [AHI] ≥ 15 events per hour). MEASUREMENTS AND
resultsFor a patient with moderate-to-severe OSA, CPAP therapy has an incremental cost-effectiveness ratio (ICER) of $15,915 per QALY gained for the lifetime horizon. Over the lifetime horizon in a population with 50% prevalence of OSA, full-night polysomnography in conjunction with CPAP therapy is the most economically efficient strategy at any willingness-to-pay greater than $17,131 per-QALY gained because it dominates all other strategies in comparative analysis.
conclusionsFull-night polysomnography (PSG) is cost-effective and is the preferred diagnostic strategy for adults suspected to have moderate-to-severe OSA when all diagnostic options are available. Split-night PSG and unattended home monitoring can be considered cost-effective alternatives when full-night PSG is not available.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.