OSA to impact 77M U.S. adults by 2050

When a storm threatens, seasoned sailors don’t wait - they read the skies, scan their radar and chart a new course before the first wave hits. The same urgency applies to multiple sleep health stakeholders, including policy makers, payers, health systems and sleep specialists. They now must take the helm to help primary care providers (PCPs) find their role and responsibilities, as they all try to navigate the swelling surge of obstructive sleep apnea (OSA). Currently, a forecast this serious can’t be ignored: by 2050, nearly 77 million U.S. adults aged 30–69 are expected to be affected, with women driving much of that increase.¹ Already, patients are caught in turbulent waters, battling comorbidities like hypertension, diabetes and obesity. Keeping them afloat will require that all hands be on deck to steer their care with foresight, precision and decisive action.

Think Ahead to Set the Course

In a first of its kind study, researchers share their findings from an open-cohort dynamic population model, based on age, sex and body mass index (BMI) trends to project the 30-year burden of OSA in the U.S. from 2020 to 2050. In “Projecting the 30-Year Burden of Obstructive Sleep Apnoea in the USA: a prospective modelling study,” published in The Lancet Respiratory Medicine in August 2025, researchers highlight the urgent need for broader screening, earlier diagnosis and faster access to effective therapy due to the increasing prevalence of OSA, particularly among females.¹

With this forward-looking evidence, OSA now has the opportunity to get the attention it deserves. Sleep health, in general, needs to be treated with the same urgency as other chronic diseases in the U.S. like diabetes (38 million adult cases²), atrial fibrillation (10 million adult cases³) and hypertension (120 million cases⁴) – most of which are diagnosed by PCPs. With the increasing burden of almost 77 million OSA patients on the horizon, in particular older men and women, it’s important that sleep specialists, who typically diagnose OSA, coordinate with PCPs to determine each other’s roles and responsibilities, as well as envisage care pathways to ensure that patients receive the necessary interventions from the right provider at the right time to improve outcomes.

Despite its growing prevalence, OSA is undiagnosed in 80% of cases,⁵ leading millions to suffer and have an increased risk for cardiovascular disease,⁶ diabetes⁷ and depression,⁸ as well as lost workplace productivity⁹ and higher healthcare costs. Patients with undiagnosed OSA incur $2,645 to $5,288 more in annual medical expenses compared to those without OSA (equivalent to $1,950 to $3,899 in 2015 U.S.$).¹⁰

Meanwhile, the public’s understanding of OSA remains limited. Many people don’t associate it with these comorbidities and downplay sleepiness as “normal.” Too often, OSA is considered a male disorder, resulting in women less likely to be referred and tested for, or diagnosed with, OSA, even when reporting similar symptoms.¹¹ As the study estimates a 64% increase in the number of women with OSA, especially after menopause,¹ this has significant clinical implications.

Until now, long-term projections related to OSA have been limited. The study emphasizes the importance of considering sex-specific strategies and demographic trends when projecting the future burden of OSA, ensuring that healthcare planning and targeted early interventions adequately address the needs of these populations.¹

Act Now to Steer Clear

To make sleep truly essential, coordinated action across the entire healthcare ecosystem is necessary. Policy makers must elevate sleep in national health plans and prevention strategies, create targeted policy measures, and fund sleep research at a scale that matches its health impact. Payers must bring PCP reimbursement policies in line with clinical guidelines, remove authorization barriers, and provide appropriate coverage for diagnostics and treatments.

As the dedicated experts on the topic of OSA, sleep specialists should serve as the primary consultant in this therapeutic area and oversee actions with all stakeholders involved in order to:

• Guide policy makers, payers and health systems on the best ways to navigate forward.
• Coordinate with PCPs on the standard of care for assessing sleep issues, just like for hypertension, diabetes and other issues, as part of a routine health check.
• Ensure that the next generation of doctors and nurses are educated about sleep.

These stakeholders must act now to shift public perception about the importance of sleep because the health economic impact of untreated sleep disorders is staggering. Treating the millions of undiagnosed OSA patients is projected to cost $67.1 billion but leaving it untreated will cost the system a staggering $202.9 billion.¹²

Just like at sea, forecasting what lies ahead, along with immediate, decisive action, will give these stakeholders the advantage to take control of the ship and sail through the storm, helping to ensure that the growing burden of OSA can be clinically managed by both sleep specialists and PCPs, and integrated across systems of care, resulting in improved patient outcomes.