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Sleep Medicine’s Diagnostic Equity Problem May Widen Dementia Disparities

The communities carrying the greatest burden of poor sleep are often the least likely to receive a diagnosis or treatment. As research on sleep and cognitive health develops, that gap deserves greater attention as a potential contributor to wider brain-health inequities.

Sleep Disorders as a Potentially Modifiable Factor in Cognitive Health

The relationship between sleep disorders and cognitive health has become an important focus of brain health research. Sleep disorders are associated with a significantly higher risk of Alzheimer's disease and all-cause dementia, and the biological mechanisms involving the brain's own waste-clearance system are increasingly better understood.

Long-Term Sleep Disorder Management as Part of Dementia Care Infrastructure

As brain health changes, sleep disorders may become harder to self‑manage and accelerate cognitive decline. Integrating structured, caregiver‑inclusive sleep care into dementia pathways is a necessity.

Rethinking Diagnostic Sufficiency in OSA: Aligning HSAT, Risk, and Access to Care

Assessing how inconsistent and outdated OSA diagnostic guidelines across countries influences patient access to care, and health system burden.

GLP-1s, PAP and the Future of Multimodal Sleep Therapy: OSA Care Requires Clearer Clinical Guidance

GLP-1/GIP therapies are reshaping OSA care, but their arrival has exposed a critical guideline gap. Current guidelines lack operational direction on reassessment, multimodal sequencing and therapy discontinuation, risking unverified disease resolution assumptions and unsafe therapy abandonment.

OSA Underdiagnosis: A World of Difference, A Common Challenge

At World Sleep 2025, international experts shared firsthand insights on what's broken and what's working in global OSA diagnosis. Hear the discussion on tackling missed diagnosis, challenging outdated norms and building new models of care.

Revisiting OSA Care Standards: Aligning Treatment with Phenotype

Obstructive sleep apnea (OSA) is biologically heterogeneous, and distinct phenotypes show different treatment responses and adherence patterns. The current uniform, AHI‑driven care is misaligned with how the disease actually presents in many patients.

Capitation is not Value: Rewarding Continuity, Not Containment

For payers, the central question is not how to cap costs in sleep care, but how to sustain measurable reductions in downstream utilization over time.

Embedding Life Context Into OSA Therapy Selection and Adherence Frameworks

In sleep therapy, biology sets the stage, but life circumstances often decide the outcome.

The Missing Link: Re-engagement and Continuity in OSA Care

OSA is chronic yet care systems treat drop-off as an endpoint. Re-engagement and continuity pathways are essential to improving outcomes and reducing inequities.

Why the OSA Journey Needs Long-Term, Adaptive Treatment Models

OSA is chronic and affects nearly a billion people, yet care remains rigid and binary. It’s time for a model that’s flexible and supports long-term care.

Underdiagnosed and Overlooked: The OSA Challenge

OSA is a prevalent yet underdiagnosed disease, currently affecting over 50 million adults in the United States, yet up to 80% of cases remained undiagnosed1, 2 — demanding urgent action to close the care gap.

The Economic Value of Treating OSA with PAP Therapy

By reducing acute care costs and improving management of high-cost comorbidities, PAP therapy offers a compelling opportunity to reduce total cost of care.

Action Needed to Navigate the Rising Tide of OSA

Immediate action is needed by multiple sleep stakeholders to ensure the future burden of OSA can be clinically managed by sleep specialists and primary care providers (PCPs)

Sleep Care Reform Is Long Overdue

Making sleep essential requires more than recognition—it demands policy, funding, and clinical integration across systems of care.

The High Price of Ignoring Sleep

Recognizing sleep as essential marks progress, but real-world change in care delivery, education, and funding remains critically overdue.

A Call to Invest in Rest: Better Sleep Improves Mental Health

Along with the economy, productivity and health systems, we must invest in rest as a serious policy principle. It is that integral to our health.

Beyond AHI: The Search for More Robust OSA Diagnostic Criteria

AHI as the sole or primary OSA diagnostic criteria puts too many people at risk by preventing treatment for those who need it.

How AHI Came to Be the Standard Diagnostic Measure

The AHI and OSA are deeply intertwined, but questions have been asked about AHI as a metric of OSA diagnosis and classification from the beginning.

Beyond the Stereotypes: Obstructive Sleep Apnea in Women

A growing body of research shows how gender biases and stereotypes of obstructive sleep apnea stand in the way of women receiving the help they need.

The Insufficiency of Today's Approach to COMISA Care

Despite clear recognition as a standalone condition, COMISA remains not only underdiagnosed but poorly managed, falling through many systemic cracks.

The Increasing Burden of Insomnia and COMISA

Clinicians, policymakers and industry leaders must give greater attention to the impact of COMISA on individuals, health systems and economies.

COMISA: The Underdiagnosis Continues

As comorbid insomnia and OSA (COMISA) is recognized as a standalone condition, diagnostic approaches lack, resulting in high rates of underdiagnosis.

CBT-I Addresses Root Causes of Insomnia, Not Just Symptoms

CBT-I ushers in a new level of promise for patients with insomnia as a true treatment that is non-invasive and free of pharmacological interactions.

How P4 Medicine Can Improve Diagnosis and Treatment of OSA

Current approaches to OSA leave many struggling, often going undiagnosed and untreated. A P4 mindset can shift thinking to identify at-risk patients earlier.

The Value of Clincial Trial and Real-World Data Together

RWE with RCTs blends theory with practice to increase patient representation and identify long-term trends, enhancing the ability to advance patient care.

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