Obstructive Sleep Apnea Linked to 71% Higher Risk of Cardiovascular Events and Mortality

New research, slated for presentation at the European Congress on Obesity (ECO 2026), highlights a significant health risk associated with obstructive sleep apnea (OSA). The study reveals that individuals diagnosed with OSA face a substantially elevated risk of adverse health outcomes.

Individuals diagnosed with obstructive sleep apnea (OSA) have a 71% elevated risk of experiencing cardiovascular events (CVEs) or death from any cause compared to those without the condition.

Beyond this primary finding, the research also uncovered that OSA patients exhibit higher rates of developing certain comorbidities and utilize more healthcare resources.

Study Details

This comprehensive research was a collaborative effort involving Imperial College Health Partners, Imperial College Healthcare NHS Trust, and Eli Lilly and Company. Eli Lilly, a pharmaceutical company known for its obesity and diabetes medications, sponsored the study. The findings are scheduled to be formally presented at ECO 2026, which will take place in Istanbul, Turkey, from May 12-15.

Understanding Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a medical condition defined by recurrent upper airway obstruction during sleep. This interruption in breathing is widely recognized to diminish both sleep quality and overall life quality, and it is a known contributor to an increased risk of cardiovascular issues.

The prevalence of obesity and overweight among individuals with OSA is notably high, ranging from 40% to 70%, with obesity often correlating with more severe forms of the condition. Prior studies have consistently indicated that weight loss can lead to a reduction in OSA severity and potentially enhance cardiometabolic health. Despite the availability of guideline-directed therapies, such as continuous positive airway pressure (CPAP), OSA frequently remains underdiagnosed and undertreated, carrying significant implications for morbidity, mortality, and healthcare resource utilization (HCRU).

Research Objectives and Methodology

The primary objective of this study was to quantify the increased risk of the combined endpoint of cardiovascular events (CVEs) or all-cause mortality among adults (aged 18 years or older) with an OSA diagnosis, in comparison to a matched group of adults without OSA. Secondary objectives focused on evaluating the risk of developing key comorbidities, including diabetes and osteoarthritis, and comparing healthcare resource utilization, encompassing primary care visits, outpatient attendances, and inpatient admissions.

The analysis drew upon de-identified linked electronic health records, covering 2.9 million residents in North-West London, United Kingdom. Researchers identified 20,300 individuals with an OSA diagnosis, who were then meticulously matched with 97,412 comparable individuals without OSA. Each OSA participant was matched with up to five comparators based on a range of factors, including demographics, socioeconomic deprivation, smoking status, obesity status, comorbidity count, prior CVEs, and survival at the index date (the initial OSA diagnosis date for the OSA participant).

Statistical modeling was employed to accurately determine the odds of CVEs or all-cause mortality for those with OSA. Participants were monitored for a period of up to four years from the index date until an endpoint, March 2025, or loss to follow-up or de-registration. Healthcare resource utilization (HCRU) and associated costs were calculated using national unit costs and subsequently compared using paired statistical methods.

Key Findings

The study definitively found a consistent 71% higher risk of CVEs or all-cause mortality among individuals with OSA when compared to their matched control group without the condition.

Specific findings within the four-year follow-up period post-index date include:

• Cardiovascular Events or Mortality:

  • 26.3% (5,342 individuals) of those with OSA experienced CVEs or all-cause mortality.
  • This compares to 17.5% (17,079 individuals) of matched controls.

• Obesity Prevalence:

  • Among participants with OSA, 57.2% (11,613) were living with obesity.
  • Similarly, 56.7% (55,264) of the matched participants without OSA also had obesity.

• Development of New Conditions: Among participants who did not have specific conditions at the index date, individuals with OSA exhibited significantly higher proportions of developing:

  • Obesity: 5.6% vs 4.0% in controls
  • Diabetes: 6.8% vs 4.6% in controls
  • Osteoarthritis: 4.2% vs 3.0% in controls
  • Anxiety: 5.2% vs 3.2% in controls
  • Depression: 4.7% vs 3.0% in controls

• Healthcare Resource Utilization (HCRU): Median HCRU was consistently greater for individuals with OSA across several categories:

  • Primary care visits: 21 per person-year (ppy) compared to 14 ppy for controls.
  • Outpatient attendances: 4 ppy compared to 1 ppy for controls.
  • Inpatient days: 1 ppy compared to 0 ppy for matched controls.