OBJECTIVES: Quantify obstructive sleep apnea (OSA) prevalence and characterize sociodemographic and health characteristics of OSA patients by excessive daytime sleepiness (EDS) severity, in the EU5 (UK, France, Germany, Spain, Italy) and US.

METHODS: Data from EU5 2020 (n=62,319) and US 2019 (n=74,994) National Health and Wellness Survey were utilized, and directly standardized using country-specific weighting. In total, 2,218 EU5 and 5,175 US respondents self-reported both physician-diagnosed OSA and having experienced OSA symptoms in previous 12 months. Respondents were categorized as having normal daytime sleepiness (≤10) or EDS (mild:11-12; moderate:13-15; severe:16-24) using the Epworth Sleepiness Scale (ESS). Results were weighted to be representative of age, sex, (EU5, and US), and race (US).

RESULTS: Weighted estimates showed OSA to be more prevalent in the US than EU5, with 6.1% (16.1m) EU5 and 9.8% (24.5m) US adults having experienced OSA symptoms, and 4.2% (11.1m) EU5 and 8.4% (21m) US adults reporting diagnosed OSA. Overall, 3.5% (9.3m) EU5 and 7.1% (17.8m) US had both diagnosed and symptomatic OSA.

Average ESS was in the normal range (Mean [SD] among diagnosed/symptomatic OSA respondents: 8.70±5.53 [EU5] and 8.45±5.98 [US]). However approximately one-third of OSA patients in both EU5 and US experienced pathological EDS (EU5/US:35%/33%); around a quarter of patients with OSA reported moderate or severe EDS (EU5/US; mild:10%/9%, moderate:11%/10%, severe:13.0%/15%).

The proportion of patients with EDS appeared empirically higher and more severe in the <65 subgroup (EU5/US No EDS 61%/63%, Mild EDS 11%/9%, Moderate EDS 13%/11%, Severe EDS 15%/17%) vs the ≥65 subgroup (No EDS 72%/76%, Mild EDS 9%/8%, Moderate EDS, 9%/7%, Severe EDS 9%/8%).

CONCLUSIONS: OSA prevalence was higher in the US than EU5; however, EDS prevalence was similar between regions. Despite the average ESS score being in the normal range, a substantial percentage of respondents reported severe EDS. EDS severity appeared higher in younger patients.