Obstructive sleep apnea and associated attrition, active component, U.S. Armed Forces, January 2004-May 2016

Obstructive sleep apnea (OSA) is a growing health concern in both civilian and military populations. Individuals who suffer from OSA have increased rates of cardiovascular disease, chronic fatigue, motor vehicle accidents, cognitive impairment, and post-traumatic stress disorder. Data from the Defense Medical Surveillance System (DMSS) were utilized to examine the incidence of OSA and associated attrition from service in active component military members from 1 January 2004 through 31 May 2016. The study identified 223,731 incident cases of OSA with an overall incidence rate of 139.2 per 10,000 person-years, between 2004 and 2015. Rates increased more than 3-fold between 2004 and 2015. In 2015, 48.1% of all incident cases of OSA were diagnosed in the last year of service. The high percentage of cases diagnosed prior to separation from service is concerning because OSA is a treatable and partially preventable disease. OSA represents a large health and economic burden for the armed services and yet there are persistent research gaps in appropriate screening and prevention strategies to improve both individual health and mission performance.