A comparison of six health systems — the United Kingdom, France, Germany, the United States, Australia, and Japan — reveals a consistent pattern: Despite radically different healthcare models, all exclude sleep disorders from chronic disease frameworks. OSA is managed episodically through device provision rather than long-term care pathways. The consistency of this pattern across systems suggests a structural design issue rather than a local policy failure, and points toward the need for OSA reclassification as a chronic condition requiring continuous management.