Obstructive Sleep Apnea – A Major and Underdiagnosed Health Challenge

Obstructive sleep apnea (OSA) is one of the most common sleep-related breathing disorders worldwide. In 2019, it was estimated to affect approximately 936 million adults globally, with hundreds of millions experiencing moderate to severe disease.

OSA occurs when the upper airway repeatedly collapses during sleep, leading to breathing interruptions, drops in blood oxygen levels, and fragmented sleep. These repeated nighttime events cause intermittent hypoxia and frequent arousals, which often result in:

• Excessive daytime sleepiness

• Impaired concentration and cognitive performance

• Mood disturbances

• Reduced quality of life

If left untreated, OSA is associated with serious long-term health risks, including hypertension, cardiovascular disease, stroke, and type 2 diabetes.

The Economic and Healthcare Burden

OSA is not only a medical concern but also a major societal challenge. In the United States alone, the estimated annual economic burden of undiagnosed sleep apnea exceeds $150 billion, driven by increased healthcare utilization, reduced workplace productivity, motor vehicle accidents, and injury-related costs.

Despite advances in diagnostic methods, OSA remains heavily underdiagnosed. It is estimated that up to 80% of moderate-to-severe OSA cases remain undetected. For example:

• The estimated prevalence of moderate-to-severe OSA among U.S. adults aged 30–69 is approximately 14–15%.

• In contrast, diagnosed sleep apnea prevalence in Finland between 2016–2019 was only 3.7%, highlighting a substantial diagnostic gap.

Long waiting times for sleep studies — in some systems ranging from months to over a year — further contribute to delayed diagnosis and untreated disease progression.

The Need for Smarter Diagnostic Solutions

In Nordic countries, obstructive sleep apnea is commonly diagnosed using at-home night polygraphy (Home Sleep Apnea Test, HSAT), where patients sleep in their own bed while physiological signals are recorded and later analyzed according to international AASM criteria. Diagnosis is based on the Apnea–Hypopnea Index (AHI), which measures the number of breathing interruptions per hour of sleep.

While effective, current diagnostic pathways often require significant manual analysis, clinical resources, and patient logistics.

There is a clear need for scalable, low-burden technologies that can support earlier detection, reduce diagnostic delays, and optimize healthcare resource use.

elive.Care is being investigated as a solution designed to support this need by enabling efficient detection of moderate-to-severe OSA using established AHI thresholds.