Projecting the 30-Year Burden of Obstructive Sleep Apnea in the United States.

IMPORTANCE Obstructive sleep apnea (OSA) is a common disorder that is associated with major public health and economic burden across the United States (U.S.). Previous studies assessed the current-day prevalence of OSA, but to guide public health policies and management pathways OBJECTIVE: To estimate the burden of OSA across the U.S. through 2050. DESIGN, SETTING, AND PARTICIPANTS In this modeling study, historical data on OSA prevalence in the U.S. were extracted from a previously published longitudinal cohort study. U.S. Population characteristics (age, sex) were obtained from relevant and validated population data sources, and data on body mass index (BMI) were obtained from the National Health and Nutrition Examination Survey (NHANES) and the Wisconsin Sleep Cohort. MAIN OUTCOMES AND MEASURES To project the OSA burden (cases and prevalence) into 2050, an open cohort dynamic population Markov model was developed. RESULTS Based on projected changes in U.S. age, sex, and BMI population distributions, the model predicts a significant rise in obstructive sleep apnea (OSA) over the next three decades. By 2050, the prevalence of OSA (AHI≥5/h) is expected to increase by 35% to 46%, resulting in 77 million cases. We estimate that females will see a larger relative increase, with a 64% rise to 30 million cases, while males are projected to experience a more moderate increase of 19% to 55%, or 46 million cases. CONCLUSIONS AND RELEVANCE In this modeling study of future OSA burden, projections indicate that OSA will affect nearly 77 million adults aged 30-69 years across the U.S. into 2050, with disproportionate relative growth among females. These findings highlight the urgent need for targeted public health strategies and revise access to diagnosis and follow-up pathways to address the growing prevalence of OSA, particularly among females.