Unmasking obstructive sleep apnea: Estimated prevalence and impact in the United States.
Level 3 - non-randomized controlled study
Systematic review and epidemiological projection model based on observational prevalence data
PubMed 40957495 · doi:10.1016/j.rmed.2025.108348
What was done
A systematic review was conducted to identify adult obstructive sleep apnea (OSA) prevalence studies using the AHI 4 criterion (apneas plus hypopneas with >=4% oxygen desaturation; threshold >=5 events/hour). Age- and sex-specific prevalence rates were calculated from eligible studies to establish a 2004 baseline. The obesity population attributable fraction was then applied to project 2024 US prevalence and severity distributions (mild: 5-<15, moderate: 15-<30, severe: >=30 events/hour) among adults aged 20 years and older.
What was found
An estimated 83.7 million US adults (32.4% overall) were projected to have OSA in 2024. This included 49,459,041 males (39.1% male prevalence; 59% of cases) and 34,257,378 females (26.0% female prevalence; 41% of cases). By severity, 52% of cases were mild, 30% moderate, and 18% severe.
Why it matters
This study provides an updated national benchmark indicating that nearly one in three US adults meets criteria for OSA, driven in part by rising obesity rates. It underscores a large potential burden of undiagnosed sleep-disordered breathing.
Limits
The abstract does not state the number of studies included or their sample sizes. Estimates are projected via statistical modeling based on a 2004 baseline rather than direct contemporary clinical testing, and the model assumes obesity trends are the primary driver without directly capturing other temporal changes in diagnostic practices or risk factors.