Epidemiological Analysis of Sleep Apnea-Related Deaths: 2013-2023

Abstract

Objectives: This study aims to conduct a comprehensive epidemiological analysis of mortality associated with sleep apnea in the period spanning from 2013 to 2023. Methods: This is a cross-sectional, retrospective, and epidemiological study. Mortality rates due to sleep disorders from 2013 to 2023 were analyzed based on data from DAENT, stratified by age group, sex, place of occurrence, race/ethnicity, certifying professional, place of residence, category of death notification, and number of deaths. Results: Between 2019 and 2023, 120 deaths related to sleep apnea were recorded in Brazil, with a progressive increase, peaking in 2023 (33 cases). Males predominated (49 men vs. 33 women), consistent with higher prevalence and severity in men. Most deaths occurred in the elderly, especially those aged 70–79 and age equal to or greater than 80 years old, reinforcing the link between aging, comorbidities, and apnea complications. Pediatric cases were rare. White (34) and brown (16) individuals were the most affected. Regionally, most deaths occurred in the Southeast (56) and Northeast (32), followed by the South, Central-West, and North. The North, with no cases in 2019–2020, had 5 in 2023. These patterns may reflect population density, healthcare access, and diagnostic capacity. The increase also suggests greater recognition of apnea as a contributing cause of death, despite evident limitations. Conclusion: Although deaths from sleep apnea have increased, the total remains low given the high prevalence in the general population. It is estimated that 5%–14% of adults have obstructive sleep apnea, pointing to probable underreporting in official records. Apnea is often underdiagnosed, rarely investigated as a contributing cause, and seldom included on death certificates, limiting the accuracy of epidemiological data. The lack of standardized clinical protocols for identifying apnea in hospitalized or deceased individuals contributes to this underrecognition. Therefore, the actual number of deaths in which apnea plays a significant role is likely much higher. Expanding professional awareness, improving early diagnosis, and enhancing surveillance strategies may help generate more accurate data and support better understanding of sleep-related mortality.