. Author manuscript; available in PMC: 2017 Jun 5.

Published in final edited form as: Sleep Med Clin. 2017 Mar;12(1):137–147. doi: 10.1016/j.jsmc.2016.10.006

Table 3.

Outcomes and costs of different diagnostic and therapeutic strategies for obstructive sleep apnea among 1000 hypothetical Medicaid patients referred for testing and treated for 1 year if positive

Measure	Diagnostic Strategies		Diagnostic and Therapeutic Strategies Test-and-Treat
	PSG (gold standard)	Type 3 monitor alone (PT)	PSG + fixed titration CPAP (gold standard)	Home monitor (PT) + autotitrating CPAP	Home monitor (PT): followed by split-night PSG, fixed titration CPAP if PT positive
Total cost ($)	652,830	200,700	1,244,905	811,129	1,112,731
Cost difference of PT vs PSG alone ($)	N/A	452,130	—	—	—
Cost differences of PT + APAP vs sleep laboratory strategy ($)	—	—	N/A	433,776	132,174

All numbers are for 1000 patients at high risk of OSA diagnosis. For the diagnostic testing, the cost-savings for the diagnosis of OSA using PTwas $452,130 compared with PSG. For the test-and-treat strategies, cost savings for PT followed by auto-PAP compared with in-laboratory split-night PSG followed by CPAP titration was $433,776.

Abbreviation: N/A, not applicable.

From The New England Comparative Effectiveness Public Advisory Council. Diagnosis and treatment of obstructive sleep apnea in adults. 2013. Available at: https://icer-review.org/wp-content/uploads/2016/01/Final-Report_January20132.pdf. Accessed August 22, 2016.