Over the past three decades, demographic changes, lifestyle shifts, and evolving healthcare patterns have increased the burden of non-communicable diseases, particularly obesity, which is a major risk factor for obstructive sleep apnea (OSA). OSA affects approximately one billion adults globally, with prevalence exceeding 30% in the United States and 24.5% in the United Kingdom. However, accurate data for the UK working-age population are limited, and rates of diagnosis and treatment remain low.
Recent evidence demonstrates that poor treatment adherence contributes to worse, greater economic burden, and worse health outcomes due to 62% of patients discontinue corrective and preventive action (CAPA) therapy. Matt Lechner et al. determined OSA prevalence and evaluated societal costs by using a productivity-based model of presenteeism and absenteeism.
This study utilized the data from the 2021 census-based representative samples, which included 1,378 UK and 4,218 USA non-organized adults aged ≥18 years or older. Data was collected through electronic interviews conducted by using Dynata during November 2021. Finally, a total of 840 UK (female = 51.7%, male = 48.3%, White = 91%) and 3,523 USA (female = 52.3%, male = 47.7%, White = 78.5%) participants were involved after exclusion of incomplete responses (538 UK and 695 USA).
To estimate the productivity losses of the workplace linked to OSA, a computable general equilibrium (CGE) macroeconomic model was applied. This model assessed productivity influences among working-age adults aged from 18 years to 64 years. It incorporated survey data to estimate OSA prevalence and used established productivity impairment estimates. Together, these inputs were employed to assess the overall economic burden of OSA in the United Kingdom and the United States.
The prevalence of OSA was found to be 19.5% in the UK and 22.8% in the USA. Among working-age adults, approximately 7% of the UK workforce and 30% of the US workforce met the study criteria for OSA.
In the UK, total annual productivity losses were estimated at £4.22 billion, which represented 0.2% of national gross domestic product (GDP). The average annual productivity loss per worker with OSA was around £1,840 when compared to an estimated £1,363/patient for treatment of CAPA, such as healthcare, as well as supportive care costs.
In the United States, the estimated total annual productivity loss due to OSA was $180.2 billion, representing approximately 0.94% of GDP at a 30% prevalence rate. This corresponds to an average annual loss of $3,727/affected worker with OSA. The annual CAPA treatment cost of $1,660.97/patient was less than half the $3,727 productivity per worker with OSA. Tax revenue losses at 30% prevalence were measured at $60.37 billion or about $1,249 per person.
This study’s limitations include that OSA was identified using self-reported symptoms rather than objective measures such as the apnea–hypopnea index, which introduces the risk of recall bias or misclassification and limits the assessment of disease severity.
Despite these limitations, OSA represents a substantial and often under-recognized burden on both health and the economy. Policymakers should prioritize targeted public health strategies and effective screening approaches, as well as early therapy for reducing the productivity losses and achieving significant annual cost savings.
Reference: Rehman U, Ahn Y, Yerushalmi E, et al. Neglected burden of obstructive sleep apnoea: workplace productivity loss in the USA and UK. Thorax. 2026;0:1–3. doi:10.1136/thorax-2025-223550
