Projecting the 30-year burden of obstructive sleep apnoea in the USA: a prospective modelling study

Obstructive sleep apnoea is a common disorder that is associated with major public health and economic burden across the USA. Previous studies have assessed the prevalence of the condition. In the present study, we aimed to estimate the burden of obstructive sleep apnoea across the USA from 2020 to 2050, to guide public health policies and management pathways.

In this prospective modelling study, historical data on obstructive sleep apnoea prevalence in the USA were extracted from a previously published longitudinal cohort study. US population characteristics (age and sex) were obtained from relevant and validated population data sources, and data on BMI were obtained from the National Health and Nutrition Examination Survey and the Wisconsin Sleep Cohort. To project the obstructive sleep apnoea burden (cases and prevalence) into 2050, we developed an open cohort dynamic population simulation model.

On the basis of projected changes in US age, sex, and BMI population distributions, the model predicts a significant rise in obstructive sleep apnoea over the next three decades. By 2050, the prevalence of obstructive sleep apnoea (apnoea-hypopnoea index ≥5/h) is expected to show a relative increase of 34·7%, from 34·3% (95% uncertainty interval [UI] 34·0-34·4) to 46·2% (46·0-46·4), resulting in 76·6 million cases. We estimate that females will see a larger relative increase than males, with a 65·4% relative increase in prevalence, from 22·8% (22·5-23·0) to 37·7% (37·4-38·0) reaching a total of 30·4 million cases. Males are projected to show a more moderate relative increase of 19·3%, from 45·6% (45·4-46·0) to 54·4% (54·2-54·7), reaching 45·9 million cases.

Projections indicate that obstructive sleep apnoea will affect 76·6 million adults aged 30-69 years across the USA in 2050, with a disproportionate growth among females compared with males. These findings highlight the urgent need for targeted public health strategies and revised access to diagnosis and follow-up pathways to address the growing prevalence of obstructive sleep apnoea, particularly among females.

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