OBJECTIVES:: Obstructive Sleep Apnea (OSA) is a highly prevalent disease with significant impact on quality of life and severe consequences if left untreated. Evident complications include an increased risk for cardiovascular diseases, metabolic and neurological disorders and an increased exposure to traffic and occupational accidents. Objective of this study was to evaluate implementation status of OSA guidelines in OECD-countries and their respective currentness. METHODS:: An electronic systematic literature search was conducted using PubMed, Google Scholar and search of existing grey literature. Identified guidelines were assessed for currentness and update schedule. Correlation between implementation status and healthcare expenditures as well as population size was estimated using Pearson's coefficient. RESULTS:: Guidelines for OSA have been implemented in 42.8% of OECD countries. Mean age of the recommendations is 5.21 years with an update schedule ranging 2-7 years. A positive correlation between implementation status and healthcare expenditures could be detected (r=0.47, p= 0.004). Correlation between implementation status and population size was low (r=0.22, p=0.190). CONCLUSIONS:: Consequences of untreated OSA, like cardiovascular comorbidities and traffic or occupational accidents occur on an individual level, but can also have significant socioeconomic impact. To realize evidence based treatment of patients with OSA and to ensure sufficient allocation of resources for treatments, providers should devote more time to implement treatment guidelines. Though the OECD countries are considered developed with advanced health care systems, not even half has implemented guidelines. Given the rapid development of evidence, update schedules of more than 3 years seem to be too long to ensure patients receiving treatment per recent state of science. Our findings show, that OSA is still not in the focus in many health care systems, especially in countries with lower health care expenditures. Considering the array of complications arising from OSA, providers and policy makers should prioritize implementation and updating of treatment guidelines for OSA.