OBJECTIVES: Central sleep apnea (CSA) occurs when the brain fails to signal the diaphragm to contract during sleep, resulting in an involuntary cessation of breathing. There are limited recent data on the economic and clinical burden of CSA among the elderly. This study evaluated the costs of this disease using data from the Medicare program. METHODS: Patients newly diagnosed with CSA between January 1, 2011 and December 31, 2013 (“cases”) were identified using the Medicare 5% Standard Analytical Files. Non-CSA controls were identified in the same time period and matched 1:1 to cases. All patients were required to have continuous enrollment 12 months before index and at least 30 days post-index diagnosis. Resource utilization and medical costs were evaluated from index diagnosis to end of continuous enrollment. Matching (exact) variables included: age group, sex, race, geographic region, Charlson comorbidity index group excluding congestive heart failure, index quarter, baseline presence of congestive heart failure and baseline presence of obesity. RESULTS: Of approximately 3.2 million patients, 1,981 cases were identified. The final analysis included 730 matched patients in both cohorts; 77.7% were male and mean age was 75 years. In the baseline period, 6.6% of patients were obese. Median follow-up duration was 32.4 months for cases and 30.8 months for controls. Compared to controls, patients with CSA had higher post-index hospitalization utilization (57.5% vs. 49.3%; p=0.002), higher number of visits across all settings (inpatient: 1.66 vs 1.21, p<0.0001; ED: 1.28 vs. 0.73, p<0.0001; Office: 51.95 vs. 19.23, p<0.0001; Outpatient: 19.94 vs. 8.55, p<0.0001), and higher medical costs ($46,112 USD vs. $28,650 USD, p<0.0001). CONCLUSIONS: Resource utilization and medical costs for elderly patients with CSA are statistically significantly higher than matched patients without CSA. These results point to the need for interventions to better manage this population.