Untreated obstructive sleep apnoea may cost the UK and US economies billions of dollars each year—and the calculations suggest that treating afflicted workers is less expensive than allowing them to work until fatigued. A new economic analysis published online in the journal Thorax indicates that the annual output loss caused by a single untreated worker exceeds the cost of medical therapy, renewing calls for workplace screening in high-risk occupations. 

Obstructive sleep apnoea is a frequent breathing problem that occurs while sleeping. The throat walls relax and narrow or completely close for 10 seconds or more, several times every hour. This constantly interrupts regular breathing. People frequently snore loudly, wake up gasping for air, and feel excessively drowsy during the day. Over time, the disorder has been linked in scientific research to heart disease, high blood pressure, diabetes, memory loss, and dementia. 

Researchers evaluated responses from 3,523 persons in the 2021 US census and 840 adults in the 2021 UK census who reported classic symptoms such as nighttime breathing pauses and excessive daytime sleepiness on at least three nights per week. Using a productivity-based economic model that examined both absenteeism (missing work) and presenteeism (decreased performance at work), they found that approximately 23% of adults in the United States and 19.5% in the United Kingdom may have obstructive sleep apnoea. Approximately 30% of working-age adults in the United States and 7% in the United Kingdom satisfied the study's requirements. 

The economic repercussions are obvious. Untreated obstructive sleep apnoea in the US might result in annual productivity losses of up to US$180.2 billion, equivalent to around ₹14.95 lakh crore at current exchange rates. This corresponds to around US$3,727 per affected worker each year, or ₹3.1 lakh. Treatment with continuous positive airway pressure (CPAP), a bedside machine that softly blasts air through a mask to keep the airway open, costs an estimated US$1,661 per year, or around ₹1.38 lakh. 

Annual productivity losses in the UK might reach £4.22 billion (roughly ₹4,430 crore), accounting for 0.2% of national GDP. When aggregated nationally into crores, the annual loss per worker is approximately £1,840, or nearly ₹19 lakh in Indian currency terms. In comparison, the treatment cost is projected to be £1,363, or roughly ₹14 lakh in comparable scales. Simply put, the lost productivity per worker exceeds the expense of providing rehabilitation. 

The authors warn that these estimations are based on symptom-based measurements rather than sleep laboratory confirmation; thus, severity could not be determined, and other causes of sleepiness could not be ruled out. Still, they arrive at the following conclusion: "Our analysis, though limited to a small subset of [obstructive sleep apnoea]-related costs, highlights that the broader workplace productivity burden of [the condition] likely exceeds the direct costs of screening and effective treatment in both the UK and USA." 

The researchers continue: "Given the significant yet often overlooked burden of [obstructive sleep apnoea] syndrome and its economic impact, we urge policymakers to allocate resources towards developing an effective screening strategy and implementing targeted public health campaigns and policies." 

According to the linked editorial, around 80-85% of persons with obstructive sleep apnoea go misdiagnosed. Those who experience daytime sleepiness are twice as likely to sustain occupational injuries and are more vulnerable to car accidents. The editorial states that improved screening algorithms, low-cost home diagnostic devices, a better understanding of CPAP adherence, and newer alternatives—such as weight-loss medications, airway surgery, nerve stimulation implants, mouth devices, and positional therapy—make workplace screening more feasible than ever before. 

However, there are still concerns about privacy, insurance costs, driving limits, and job loss. The editorial advises conducting a trial in a high-risk occupation, such as professional driving, to determine whether screening decreases accidents and absenteeism. "Early identification and treatment of [obstructive sleep apnoea], along with proactive early follow-up, could result in substantial savings, potentially amounting to billions of dollars/pounds annually in productivity costs," the study's authors report. 

For businesses and legislators alike, the message is clear: investing in sleep health may save lives while simultaneously protecting the bottom line.