Resmed, a health technology company focused on sleep, breathing, and care delivered in the home, has published a study in The Lancet Respiratory Medicine that projected a significant rise in obstructive sleep apnea (OSA) in the United States over the next three decades due to a variety of factors, including an aging population and increasing body mass index (BMI).
The study estimates that by 2050, OSA will affect nearly 77 million U.S. adults, representing a relative increase of nearly 35% from 2020 and impacting 46% of adults aged 30-69. The study is the first of its kind to estimate OSA prevalence in the United States between 2020 and 2050. It used an open-cohort dynamic population model factoring in changes in age, sex, and BMI.
What is Obstructed Sleep Apnea?
OSA is a chronic sleep-related breathing disorder where breathing repeatedly stops during sleep, affecting nearly 1 billion people globally. It is linked to serious health consequences, including hypertension, cardiovascular disease, diabetes, and even stroke. Yet, more than 80% of cases go undiagnosed and untreated. The new research highlights an urgent need for earlier diagnosis of OSA, preventative strategies, and healthcare resource allocation to address this major public health problem.
What the Study Found
“This study reaffirms that the number of people with OSA is expected to dramatically increase,” said Carlos Nunez, MD, Chief Medical Officer at Resmed and Study Co-Author. “As an industry, we must expand screening, increase awareness of symptoms among providers and consumers, and make it easier for people to get tested and treated, including at home. If we don’t act, we risk missing tens of millions of people who need access to care.”
Led by researchers at Resmed through their medXcloud academic-industry collaborative, involving global academic thought leaders in the fields of sleep and respiratory medicine, the study also found:
- A 65% relative increase in OSA prevalence among women, reaching 30.4 million by 2050: The sharp rise, attributed to factors like an aging population and underdiagnosis, underscores the need for greater awareness of how OSA presents differently in women to support earlier screening, diagnosis, and targeted treatment. This is especially prevalent in postmenopausal women, with postmenopausal women being two to three times more likely to develop it than premenopausal women. This rise is attributed to the loss of the protective effects of estrogen and progesterone, which stabilize breathing, and the changes in fat distribution, particularly in the visceral fat around the neck. The symptoms of sleep apnea in menopausal women, such as fatigue and insomnia, can overlap with menopause symptoms, leading to underdiagnosis.
- A 19% relative increase in OSA prevalence among men, reaching 45.9 million cases by 2050: This continued rise reflects ongoing risk in aging male populations as well as obesity rates among men, highlighting the need for scalable diagnostic pathways and long-term treatment strategies. Men also have anatomical and physiological factors, such as larger neck circumferences, more abdominal fat, and potentially hormonal differences, that predispose them to airway collapse during sleep.
- The impact of GLP-1 therapies on future OSA prevalence is anticipated to be limited, with reductions estimated at under 5%: Even with advances in emerging drugs, such as GLP-1s, the overall number of people affected by OSA is expected to continue growing. GLP-1 use is estimated to reduce relative OSA prevalence by only 4% by 2050, from nearly 77 million cases to nearly 74 million cases. These estimates, from a sensitivity analysis included in the study, reflect that obesity is only one of many factors contributing to OSA, and that the significant overall growth of OSA prevalence remains a public health priority.
“Understanding how the prevalence of sleep apnea may grow, and who will be most affected, is essential for shaping smarter proactive health and public health strategies,” said Atul Malhotra, MD, Senior Author of the Study, Vice Chair of Medicine for Research, Research Chief of Pulmonary, Critical Care, Sleep Medicine, and Physiology, and Peter C. Farrell Presidential Chair and Tenured Professor of Respiratory Medicine at the University of California San Diego School of Medicine, and Pulmonologist at UC San Diego Health. “This study fills an important gap by helping health systems, payers, and policymakers anticipate what’s coming so they can invest in earlier diagnosis, expand access to care, and improve long-term outcomes for millions of patients across the country.”
“Sleep apnea has long been underdiagnosed and underprioritized,” said Elroy Boers, Ph.D., Lead Author of the Study and Research Scientist at Resmed. “This is the first data-driven forecast of how OSA may evolve, evidence that can drive earlier detection, proactive care, and smarter policy.”
Earlier this year, Resmed announced results from a meta-analysis published in The Lancet Respiratory Medicine, which found that treating OSA with CPAP therapy can significantly reduce the risk of death. Together, these studies highlight the need to raise awareness, enable earlier diagnosis, and ensure ongoing care to help improve outcomes and reduce the public health burden of sleep apnea.
To read the full study, see the publication in The Lancet Respiratory Medicine.
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