The Global Burden of Obstructive Sleep Apnea

doi:10.3390/diagnostics15091088

Review

. 2025 Apr 25;15(9):1088.

doi: 10.3390/diagnostics15091088.

The Global Burden of Obstructive Sleep Apnea

Giannicola Iannella¹, Annalisa Pace¹, Mario Giuseppe Bellizzi¹, Giuseppe Magliulo¹, Antonio Greco¹, Armando De Virgilio¹, Enrica Croce¹, Federico Maria Gioacchini², Massimo Re², Andrea Costantino³, Manuele Casale⁴, Antonio Moffa⁴, Jerome R Lechien⁵, Salvatore Cocuzza⁶, Claudio Vicini⁷, Alberto Caranti⁷, Rosario Marchese Aragona⁸, Mario Lentini⁹, Antonino Maniaci⁹

Affiliations

¹ Organi di Senso Department, Sapienza University of Rome, 00161 Rome, Italy.
² Ear, Nose and Throat Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Conca 71, 60020 Ancona, Italy.
³ Department of Otolaryngology-Head and Neck Surgery, AdventHealth Orlando, Orlando, FL 32789, USA.
⁴ Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
⁵ Division of Laryngology and Broncho-Esophagology, Department of Otolaryngology-Head Neck Surgery, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium.
⁶ Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia" ENT Section, University of Catania, 95123 Catania, Italy.
⁷ Department ENT & Audiology, University of Ferrara, 44121 Ferrara, Italy.
⁸ Otolaryngology Section, Department of Neuroscience, University of Padova, 35100 Padova, Italy.
⁹ Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy.

PMID: 40361906
PMCID: PMC12071658
DOI: 10.3390/diagnostics15091088

Review

The Global Burden of Obstructive Sleep Apnea

Giannicola Iannella et al. Diagnostics (Basel). 2025.

. 2025 Apr 25;15(9):1088.

doi: 10.3390/diagnostics15091088.

Authors

Affiliations

¹ Organi di Senso Department, Sapienza University of Rome, 00161 Rome, Italy.
² Ear, Nose and Throat Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Conca 71, 60020 Ancona, Italy.
³ Department of Otolaryngology-Head and Neck Surgery, AdventHealth Orlando, Orlando, FL 32789, USA.
⁴ Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
⁵ Division of Laryngology and Broncho-Esophagology, Department of Otolaryngology-Head Neck Surgery, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium.
⁶ Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia" ENT Section, University of Catania, 95123 Catania, Italy.
⁷ Department ENT & Audiology, University of Ferrara, 44121 Ferrara, Italy.
⁸ Otolaryngology Section, Department of Neuroscience, University of Padova, 35100 Padova, Italy.
⁹ Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy.

PMID: 40361906
PMCID: PMC12071658
DOI: 10.3390/diagnostics15091088

Abstract

This study reviewed the global prevalence, health and socioeconomic impact, and management approaches of obstructive sleep apnea. The narrative review examined three key dimensions: (1) worldwide OSA prevalence across different regions, accounting for variations in diagnostic standards; (2) OSA's effects on health outcomes and socioeconomic conditions across diverse populations and healthcare systems; and (3) current global approaches to OSA diagnosis, treatment, and public health management. Despite advances in diagnosis and treatment, a large proportion of OSA cases remain undiagnosed or inadequately managed. The findings show that untreated OSA significantly increases public safety risks, particularly regarding motor vehicle and occupational accidents, while also creating a substantial pool of patients at high risk for systemic complications with severe impacts on overall health. There is a critical need for increased public awareness, universal screening approaches, and integrated care strategies to address this global health challenge and reduce its considerable socioeconomic burden. Our review uniquely addresses global disparities in OSA prevalence, clarifies the health and socioeconomic impacts that remain underexplored in the current literature, and suggests concrete strategies for public health and clinical management improvement worldwide.

Keywords: OSA; epidemiology; global burden; obstructive sleep apnea; sleep.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

**Figure 1**
PRISMA 2020 flow diagram of Obstructive Sleep Apnea global burden.

**Figure 2**
Estimated prevalence of OSAS worldwide, Benjafield et al., 2019 [2].

See this image and copyright information in PMC

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References

1. Young T., Peppard P.E., Gottlieb D.J. Epidemiology of obstructive sleep apnea: A population health perspective. Am. J. Respir. Crit. Care Med. 2002;165:1217–1239. doi: 10.1164/rccm.2109080. - DOI - PubMed
1. Benjafield A.V., Ayas N.T., Eastwood P.R., Heinzer R., Ip M.S.M., Morrell M.J., Nunez C.M., Patel S.R., Penzel T., Pépin J.L., et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: A literature-based analysis. Lancet Respir Med. 2019;7:687–698. doi: 10.1016/S2213-2600(19)30198-5. - DOI - PMC - PubMed
1. Dempsey J.A., Veasey S.C., Morgan B.J., O’Donnell C.P. Pathophysiology of sleep apnea. Physiol. Rev. 2010;90:47–112. doi: 10.1152/physrev.00043.2008. - DOI - PMC - PubMed
1. Lévy P., Kohler M., McNicholas W.T., Barbé F., McEvoy R.D., Somers V.K., Lavie L., Pépin J.L. Obstructive sleep apnoea syndrome. Nat. Rev. Dis. Primers. 2015;1:15015. doi: 10.1038/nrdp.2015.15. - DOI - PubMed
1. Javaheri S., Barbe F., Campos-Rodriguez F., Dempsey J.A., Khayat R., Javaheri S., Malhotra A., Martinez-Garcia M.A., Mehra R., Pack A.I., et al. Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences. J. Am. Coll. Cardiol. 2017;69:841–858. doi: 10.1016/j.jacc.2016.11.069. - DOI - PMC - PubMed

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[1] Young T., Peppard P.E., Gottlieb D.J. Epidemiology of obstructive sleep apnea: A population health perspective. Am. J. Respir. Crit. Care Med. 2002;165:1217–1239. doi: 10.1164/rccm.2109080. - DOI - PubMed

[2] Young T., Peppard P.E., Gottlieb D.J. Epidemiology of obstructive sleep apnea: A population health perspective. Am. J. Respir. Crit. Care Med. 2002;165:1217–1239. doi: 10.1164/rccm.2109080. - DOI - PubMed

[3] Benjafield A.V., Ayas N.T., Eastwood P.R., Heinzer R., Ip M.S.M., Morrell M.J., Nunez C.M., Patel S.R., Penzel T., Pépin J.L., et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: A literature-based analysis. Lancet Respir Med. 2019;7:687–698. doi: 10.1016/S2213-2600(19)30198-5. - DOI - PMC - PubMed

[4] Benjafield A.V., Ayas N.T., Eastwood P.R., Heinzer R., Ip M.S.M., Morrell M.J., Nunez C.M., Patel S.R., Penzel T., Pépin J.L., et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: A literature-based analysis. Lancet Respir Med. 2019;7:687–698. doi: 10.1016/S2213-2600(19)30198-5. - DOI - PMC - PubMed

[5] Dempsey J.A., Veasey S.C., Morgan B.J., O’Donnell C.P. Pathophysiology of sleep apnea. Physiol. Rev. 2010;90:47–112. doi: 10.1152/physrev.00043.2008. - DOI - PMC - PubMed

[6] Dempsey J.A., Veasey S.C., Morgan B.J., O’Donnell C.P. Pathophysiology of sleep apnea. Physiol. Rev. 2010;90:47–112. doi: 10.1152/physrev.00043.2008. - DOI - PMC - PubMed

[7] Lévy P., Kohler M., McNicholas W.T., Barbé F., McEvoy R.D., Somers V.K., Lavie L., Pépin J.L. Obstructive sleep apnoea syndrome. Nat. Rev. Dis. Primers. 2015;1:15015. doi: 10.1038/nrdp.2015.15. - DOI - PubMed

[8] Lévy P., Kohler M., McNicholas W.T., Barbé F., McEvoy R.D., Somers V.K., Lavie L., Pépin J.L. Obstructive sleep apnoea syndrome. Nat. Rev. Dis. Primers. 2015;1:15015. doi: 10.1038/nrdp.2015.15. - DOI - PubMed

[9] Javaheri S., Barbe F., Campos-Rodriguez F., Dempsey J.A., Khayat R., Javaheri S., Malhotra A., Martinez-Garcia M.A., Mehra R., Pack A.I., et al. Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences. J. Am. Coll. Cardiol. 2017;69:841–858. doi: 10.1016/j.jacc.2016.11.069. - DOI - PMC - PubMed

[10] Javaheri S., Barbe F., Campos-Rodriguez F., Dempsey J.A., Khayat R., Javaheri S., Malhotra A., Martinez-Garcia M.A., Mehra R., Pack A.I., et al. Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences. J. Am. Coll. Cardiol. 2017;69:841–858. doi: 10.1016/j.jacc.2016.11.069. - DOI - PMC - PubMed

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The Global Burden of Obstructive Sleep Apnea

Affiliations

The Global Burden of Obstructive Sleep Apnea

Authors

Affiliations

Abstract

Conflict of interest statement

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Abstract

Conflict of interest statement

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