The Global Initiative for Obstructive Sleep Apnea (GIFOSA): Rationale, Strategic Framework, and Call to Action

Obstructive sleep apnea (OSA) is one of the most prevalent chronic sleep disorders worldwide, affecting an estimated nearly one billion adults globally, and is increasingly recognized as a major contributor to cardiometabolic disease, impaired quality of life, and escalating healthcare costs. Despite substantial advances in understanding OSA pathophysiology, diagnosis, and treatment, significant disparities persist in access to care, implementation of evidence-based practice, and long-term outcomes across regions and healthcare systems. The Global Initiative for Obstructive Sleep Apnea (GIFOSA) was established as an implementation-focused initiative to address these challenges through a coordinated, multidisciplinary framework that goes beyond existing regional and national efforts by integrating global coordination, action-oriented implementation strategies, practical tools, and policy engagement. This paper presents the conceptual foundations of GIFOSA and outlines its strategic pillars: strengthening clinical and scientific foundations, building workforce capacity, advancing person-centered management, and integrating OSA into population health and policy agendas. Central to its pragmatic structure is a focus on implementation feasibility, including context-sensitive care pathways, task-sharing approaches, and technology-enabled diagnostics and management strategies that can be adopted across resource levels. By emphasizing cross-disciplinary collaboration, technological innovation, and alignment with health systems and policy priorities, GIFOSA seeks to bridge the gap between knowledge and practice while promoting equitable access to diagnosis and treatment. The initiative further highlights the importance of prevention, digital health integration, and global research collaboration to support sustainable and measurable improvements in OSA care worldwide.Graphical Abstract is available with this article.