Mild obstructive sleep apnea was associated with high cardiometabolic comorbidity and higher rates of anxiety (28% vs 21%) and depression (24% vs 19%) compared to moderate-to-severe disease.
Cohort (n=119,356)
What are the clinical characteristics, comorbidities, and healthcare resource utilization of patients with mild OSA compared to those with moderate-to-severe OSA?
Mild OSA is associated with a substantial burden of cardiometabolic and mental health comorbidities, highlighting the need for clinical recognition and management across all severity levels.
Abstract Rationale Obstructive sleep apnea (OSA) is highly prevalent and associated with a broad range of comorbidities. While much of the clinical and research focus has been on moderate-to-severe OSA, less is known about the characteristics of patients with mild OSA. This study was designed to describe a cohort of patients with mild OSA using real-world data. Methods This was a retrospective cohort study conducted among patients with a home sleep test that diagnosed OSA between January 2015 and October 2023. The home sleep test data was linked to administrative claims data through tokenization. Patients were required to have ≥1 year of data prior to the sleep test. Comorbidities were identified during this 1-year period through ICD-9/10 diagnoses codes. OSA severity was categorized based on the apnea-hypopnea index (AHI) as mild (AHI 5-15 events/hour), moderate (15-30 events/hour), or severe (≥30 events/hour). Results Of 119,356 patients, 45% were classified as having mild OSA, 28% moderate, and 26% severe. Compared to patients with moderate-to-severe OSA, those with mild severity were more likely to be female (51% vs 33%), slightly younger (50y vs 52y), and had lower rates of obesity (50% vs 57%). Although less frequent than among those with moderate-to-severe OSA, cardiometabolic conditions are still prevalent among those with mild OSA, including hypertension (48%), hyperlipidemia (47%), type 2 diabetes (17%), and coronary artery disease (9%). Those with mild OSA had slightly higher rates of asthma (15% vs 11%), anxiety (28% vs. 21%), depression (24% vs. 19%), and insomnia (18% vs. 13%) compared to those with moderate-to-severe OSA. Lastly, healthcare resource use in the year prior to OSA diagnosis was similar for those with mild disease compared to moderate-to-severe OSA (27.0% vs. 24.2% with an emergency room visit and 6.4% vs. 7.2% with a hospitalization, respectively). Conclusions Mild OSA is common and frequently accompanied by cardiometabolic, mental health, and respiratory comorbidities at rates comparable to moderate-to-severe disease, along with similar rates of healthcare resource use prior to treatment These findings underscore the need to recognize and address OSA across all severity levels to improve symptoms, quality of life, and healthcare burden. This abstract is funded by: Resmed
Sterling et al. (2026) conducted a cohort in Obstructive sleep apnea (n=119,356). Mild obstructive sleep apnea vs. Moderate-to-severe obstructive sleep apnea was evaluated on Comorbidities and healthcare resource use. Mild obstructive sleep apnea was associated with high cardiometabolic comorbidity and higher rates of anxiety (28% vs 21%) and depression (24% vs 19%) compared to moderate-to-severe disease.