Double the odds? Sleep apnea can mean twice the risk of sudden death.

Over one billion individuals worldwide experience some form of sleep apnea, and the number is rising. Obstructive sleep apnea (OSA) can negatively influence quality of life (QOL) and potentially increase mortality risk.1

But the association between OSA and mortality has not been reliably estimated. However, a new review article estimates the risk of all-cause and cardiovascular mortality in individuals with OSA.1

The results are stunning:  Individuals with OSA had a nearly twofold higher risk of sudden death and cardiovascular mortality. The primary outcome of the review was the risk of all-cause sudden mortality in individuals with OSA compared with individuals without OSA. Cardiovascular mortality associated with OSA was the secondary outcome of interest.1

A team from Pennsylvania State University conducted a systematic review and meta-analysis looking at 22 studies involving more than 42,099 patients. Of these, 64% were men and the mean age was 62. The studies were geographically diverse, coming from North America, Europe, Asia, South America and Australia.1

The team’s findings showed that “people with obstructive sleep apnea had a greater risk of dying suddenly and the risk rose as patients aged.”2

Looking at the risk of all-cause sudden death associated with OSA, the relative risk (RR) for those with mild OSA was 1.16 (95% CI: 0.70 to 1.93, I2=66%), for moderate OSA was 1.72 

(95% CI: 1.11 to 2.67, I2=0%) and severe OSA was 2.87 (95% CI: 1.70 to 4.85, I2=0%).1

The point estimates of cardiovascular mortality ranged from 0.80 to 4.19. Overall, individuals with OSA had a nearly twofold higher risk than those without OSA (RR=1.94, 95% CI: 1.39 to 2.70, I2=32%).1

Certainly, sleep apnea diagnosis, treatments and interventions can help decrease this risk and other adverse outcomes are necessary to optimize survival and QOL.

“This [study] adds to the growing body of evidence that highlights the importance of screening, diagnosis and treatment of sleep apnea,” said Dr. Kannan Ramar, immediate past president of the American Academy of Sleep Medicine (AASM), quoted in U.S News & World Report.2

Ramar, who reviewed the findings, said they underscore the importance of recognizing a widespread and often underdiagnosed condition that has become a growing public health concern.2

The advent of reliable, convenient, at-home sleep apnea testing ensure that sleep physicians can prescribe and diagnose sleep apnea without a patient stepping foot in the sleep lab. This flexibility allows physicians to detect sleep apnea quickly and take the necessary steps to treat this growing health concern



Heilbrunn ES, Ssentango P, Chinchilli VM, Oh J, Ssentango AE. Sudden death in individuals with obstructive sleep apnea: a systematic review and meta-analysis. BMJ Open Respiratory Research, Volume 8, Issue 1.


Reinberg, S. Sleep apnea doubles odds for sudden death. U.S. News & World Report. August 3, 2021.

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