The number of patients with obstructive sleep apnea (OSA) is somewhere around 18 million people, according to the National Sleep Foundation. OSA has a direct relationship to other illnesses, including cardiovascular disease, diabetes, hypertension and stroke. As a result the annual cost of untreated OSA in the United States is astronomical – $65 to $165 billion dollars, according to researchers in the Division of Sleep Medicine at Harvard Medical School.

This is greater than the total cost of managing patients with asthma, heart failure, stroke and hypertension combined. OSA cost estimates from the 2010 report were based on initial diagnosis and treatment, medical costs due to co-morbidities, traffic accidents associated with OSA, workplace accidents, loss of productivity and the societal costs.

As a society we are very concerned about drunk drivers and spend around $60 billion dollars annually in ad campaigns and consumer awareness to prevent drunk driving.  But people with unmanaged OSA are about two to three times more likely to have a traffic accident, results of a 10-study metaanalysis show, and OSA related traffic accidents cost between $10 billion and $14 billion annually. How often do you see public service announcements warning about the dangers of OSA and driving?

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The United States is quickly becoming a population of older adults, and with this OSA will surely become more common. OSA prevalence is twice as high in patients aged older than 60 years, and OSA-related costs will continue to go up as our demographics shift.

In addition, we as a nation are more obese than ever before – another risk factor for OSA – which adds another population that will increase the costs associated with managing OSA.

Reading the Harvard report was eye-opening experience. OSA is an under-diagnosed and under-treated disease that needs more public attention. Please remember to talk with your patients about sleep. Refer those with sleep troubles to a sleep center for evaluation before they become part of the statistics.

Do these numbers surprise you, as much as surprised me?

Sharon M. O’Brien, MPAS, PA-C, works at Presbyterian Sleep Health in Charlotte, N.C. Her main interest is helping patients understand the importance of sleep hygiene and the impact of sleep on health.


  1. Harvard School of Medicine. The Price of Fatigue: The Surprising Economic Costs of Unmanaged Sleep Apnea. December 2012.