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. 2025 Dec;13(12):1078-1086.
doi: 10.1016/S2213-2600(25)00243-7. Epub 2025 Aug 26.

Projecting the 30-year burden of obstructive sleep apnoea in the USA: a prospective modelling study

Elroy Boers  1 , Meredith A Barrett  2 , Adam V Benjafield  2 , Jodi H Barnet  3 , Laurel A Ravelo  3 , Leanne Kaye  2 , Peter A Cistulli  4 , Jean-Louis Pépin  5 , Jeff Armitstead  2 , Kimberly L Sterling  2 , Carlos M Nunez  2 , Paul E Peppard  3 , Atul Malhotra  6
Affiliations

Projecting the 30-year burden of obstructive sleep apnoea in the USA: a prospective modelling study

Elroy Boers et al. Lancet Respir Med. 2025 Dec.

Abstract

Background: Obstructive sleep apnoea is a common disorder that is associated with major public health and economic burden across the USA. Previous studies have assessed the prevalence of the condition. In the present study, we aimed to estimate the burden of obstructive sleep apnoea across the USA from 2020 to 2050, to guide public health policies and management pathways.

Methods: In this prospective modelling study, historical data on obstructive sleep apnoea prevalence in the USA were extracted from a previously published longitudinal cohort study. US population characteristics (age and sex) were obtained from relevant and validated population data sources, and data on BMI were obtained from the National Health and Nutrition Examination Survey and the Wisconsin Sleep Cohort. To project the obstructive sleep apnoea burden (cases and prevalence) into 2050, we developed an open cohort dynamic population simulation model.

Findings: On the basis of projected changes in US age, sex, and BMI population distributions, the model predicts a significant rise in obstructive sleep apnoea over the next three decades. By 2050, the prevalence of obstructive sleep apnoea (apnoea-hypopnoea index ≥5/h) is expected to show a relative increase of 34·7%, from 34·3% (95% uncertainty interval [UI] 34·0-34·4) to 46·2% (46·0-46·4), resulting in 76·6 million cases. We estimate that females will see a larger relative increase than males, with a 65·4% relative increase in prevalence, from 22·8% (22·5-23·0) to 37·7% (37·4-38·0) reaching a total of 30·4 million cases. Males are projected to show a more moderate relative increase of 19·3%, from 45·6% (45·4-46·0) to 54·4% (54·2-54·7), reaching 45·9 million cases.

Interpretation: Projections indicate that obstructive sleep apnoea will affect 76·6 million adults aged 30-69 years across the USA in 2050, with a disproportionate growth among females compared with males. These findings highlight the urgent need for targeted public health strategies and revised access to diagnosis and follow-up pathways to address the growing prevalence of obstructive sleep apnoea, particularly among females.

Funding: Resmed.

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Conflict of interest statement

Declaration of interests EB, MAB, AVB, LK, JA, KLS, and CMN are employees of Resmed. PAC reports having an appointment to an endowed academic Chair at the University of Sydney that was established from Resmed funding, has received research support from Resmed and SomnoMed, and is a consultant to Resmed, SomnoMed, Sunrise Medical, and Eli Lilly. J-LP is supported by the French National Research Agency in the framework of the Investissements d'Avenir program (ANR-15-IDEX-02) and the e-Health and Integrated Care and Trajectories Medicine and MIAI Artificial Intelligence chairs of excellence from the Grenoble Alpes University Foundation (ANR-19-P3IA-0003). J-LP also reports lecture fees or conference travel grants from Resmed, Philips, Jazz Pharmaceuticals, Agiradom, and Bioprojet. AM is funded by the National Institutes of Health and reports income related to medical education from LivaNova, Jazz Pharmaceuticals, ZOLL, and Eli Lilly. Resmed provided a philanthropic donation to University of California San Diego, San Diego, CA, USA, but AM has not received personal income from ResMed or medXcloud. All other authors declare no competing interests.

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