Stigma and Delayed Diagnosis Are Driving Up Obstructive Sleep Apnea Costs

Fear of the continuous positive airway pressure (CPAP) mask—not the disease itself—is driving patients away from obstructive sleep apnea (OSA) diagnosis and care, surfacing as one of the most underappreciated barriers in sleep medicine. During an interview with The American Journal of Managed Care,^® Martin Hopp, MD, PhD, an otolaryngologist and sleep specialist at Cedars-Sinai Medical Center and medical director of Daybreak, explained that patients who associate OSA treatment solely with CPAP often avoid the system altogether, leaving them vulnerable to anxiety, depression, marital discord, and cognitive decline that early intervention could prevent.

"People still associate sleep apnea with a mask and a device at nighttime, and they don't want to go on CPAP," Hopp explained. That fear of treatment, he said, discourages patients from even pursuing evaluation, leaving them vulnerable to the long-term consequences of untreated OSA, including anxiety, depression, marital discord, and cognitive decline. Hopp emphasized that for patients diagnosed early with mild sleep apnea, oral devices are highly effective alternatives. "A lot of patients that are diagnosed early avoid the long-term complications," he noted.

To underscore the scale of the problem, Hopp offered a striking statistic: among men, roughly 1 in 4 has sleep apnea. He also reassured viewers that the financial barrier is lower than many assume since basic diagnosis and initial therapy are covered by virtually all medical insurance plans.

Kate Willis, vice president of government and provider strategy at Daybreak, shifted the lens to the payer side, urging health plans to reckon with the upstream cost burden of delayed diagnosis. Undiagnosed OSA drives increased emergency department visits, hospitalizations, and compounding health care expenses. Tools like Daybreak, which can facilitate diagnosis within days, offer a meaningful opportunity to intervene early. "It can really help mitigate those costs," Willis said, framing early OSA detection not just as a clinical imperative but a financial one.