Epidemiological Analysis of Sleep Disorder-Related Deaths in Brazil from 2013 to 2023

Abstract

Objectives: To examine mortality due to sleep disorders in Brazil (2013–2023), identifying demographic, regional, and temporal patterns, as well as disparities affecting diagnosis and management. Methods: A cross-sectional, retrospective, epidemiological study using DAENT data. Sleep disorder mortality from 2013 to 2023 was analyzed by age, sex, place of death, race/ethnicity, certifier, place of residence, death category, and total number of deaths. Results: Between 2019 and 2023, 163 deaths related to sleep disorders were recorded in Brazil. Annual cases ranged from 12 to 44, with a progressive increase until 2023, possibly reflecting improved diagnostic awareness or worsening population risk factors. The Southeast had the highest concentration (67), followed by the Northeast (47), South (32), North (9), and Central-West (8), highlighting demographic and healthcare disparities. There was a male predominance (78 deaths) compared to 56 among females, suggesting greater vulnerability or underdiagnosis in women. Older adults were most affected, especially those aged 70+, with 32 cases in individuals aged 80 or older, confirming aging as a key risk factor. Regarding race/skin color, most were white (80), followed by brown (38), Black (10), and Asian (2). Approximately 75% of deaths were due to sleep apnea, and 9% to insomnia. Notably, insomnia-related deaths tripled in 2021 (6) compared to 2020 (2) and 2019 (2), indicating a possible external influence. Conclusion: The 163 deaths from sleep disorders in Brazil between 2019 and 2023 reveal a relevant and underestimated public health issue. The predominance of cases in the elderly underscores the need for policies focused on screening and monitoring this high-risk group. Regional concentration in the Southeast and Northeast contrasts with underreporting or limited diagnostic access in the North and Central-West. Higher mortality among men may reflect clinical or behavioral differences by sex. Race/ethnicity data show more deaths among White (80) and "Pardos" (38) individuals, followed by Black (10) and Asian (2), reflecting broader social and health inequities. Notably, insomnia-related deaths tripled in 2021 compared to previous years, a trend that may be associated with the COVID-19 pandemic and its effects on mental health and sleep. These findings emphasize the need to improve early diagnosis, strengthen reporting systems, and integrate sleep disorders into broader public health strategies.