Abstract Introduction Patients with and without obstructive sleep apnea (OSA) often present with similar comorbid conditions, yet the extent to which comorbidity patterns differ between groups remains unclear. This study compares comorbidity type and prevalence among individuals with and without an OSA diagnosis, and how outcomes differ by sex. Methods In 2024, U.S. adults completed an online survey about their general health, OSA status, and physician-diagnosed comorbidities. Participants were classified to a diagnostic group based on self-reported OSA diagnosis and OSA symptoms: (1) asymptomatic but predisposed to OSA (n = 120), (2) symptomatic without a confirmed OSA diagnosis or treatment (n = 182), and (3) diagnosed with OSA (n = 607; including never, past, and current PAP (positive airway pressure) therapy users). Descriptive analyses identified the three most prevalent non-OSA comorbidities in each diagnostic group, including sex differences. Results A total of 909 participants were included in the analysis (mean age: 53 years; 58% female; 67% with OSA). Overall, hypertension (482/909, 53%), hypercholesterolemia (312/909, 34%), and depression (249/909, 27%) were the most commonly reported comorbidities, with women (vs. men) more frequently reporting depression (264/523, 50% vs. 52/386, 13%), and men (vs. women) more frequently reporting hypercholesterolemia (152/386, 39% vs. 110/523, 21%). Hypertension prevalence was similar across the symptomatic non-OSA group and OSA group (90/182, 49% vs. 304/607, 50%), but rates of hypercholesterolemia and depression were almost double in the symptomatic non-OSA group compared to the OSA group (hypercholesterolemia: 94/182, 52% vs. 144/607, 24%; depression: 89/182, 49% vs. 160/607, 26%, respectively). Participants in the asymptomatic non-OSA group showed the highest prevalence for hypertension (88/120, 73%) and hypercholesterolemia (74/120, 62%) compared to the symptomatic non-OSA group and OSA group. Women in the symptomatic non-OSA group and OSA group had similar rates of depression (74/136, 54% vs. 190/314, 61%). Conclusion Symptomatic participants without a confirmed OSA diagnosis had similar comorbidity patterns to those with OSA. Hypertension, hypercholesterolemia, and depression may serve as useful indicators of potential sleep-related health issues. Understanding overlapping comorbidities can help healthcare providers recognize when commonly reported conditions may reflect unrecognized OSA risk, supporting earlier screening and proactive discussions about sleep health. Support (if any) Funded by Resmed
Yu et al. (Fri,) studied this question.