A 10-year nationwide analysis of nocturnal device prescriptions for sleep apnea in France.

BACKGROUND: Sleep apnea has become an increasingly important condition to address, given its growing prevalence in the general population with positive airway pressure (PAP) and mandibular advance device (MAD) as the main treatment. This study aims to describe the evolution of PAP and MAD prescriptions in France over the past ten years, the associated healthcare costs, and the changing characteristics of both beneficiaries and prescribers. METHODS: This study is based on open access reimbursement data from the national health care system (Open LPP) between 2014 and 2023, which provide data on all PAP and MAD prescriptions within the French population. RESULTS: The number of PAP prescriptions has increased by an average of 16% per year, rising from 986,784 in 2014 to 3,362,040 in 2023. Despite reductions in reimbursement rates, healthcare expenditures have doubled, reaching 934 million euros in 2023 for PAP. Private care specialists contributed the most to the increase in prescriptions. Regarding beneficiaries, 64% of prescriptions in 2023 were for male patients compared to 70% in 2014. Meanwhile, adherence to PAP therapy have decreased with 67.6% of patients having an adherence > 4 h/day in 2018 vs. 63.6% (p = 0.03). MAD prescriptions in France increased from 8,110 in 2014 to 29,546 in 2023, representing an average annual growth of 17%. CONCLUSION: PAP and MAD prescriptions have risen markedly over the past decade in France, alongside increasing healthcare expenditures and shifting patterns of prescribers and beneficiaries.