NEW DELHI: Untreated sleep apnea is costing India an estimated Rs 2-3 lakh crore every year, according to an emergent consensus on the sidelines of ISSS 2026, the International Surgical Sleep Society’s conference. The estimate covers lost productivity, workplace accidents and excess mortality linked to the disorder.
The scale of the problem is stark. One-third of India’s population suffers from sleep apnea, and an AIIMS study puts the number of affected working-age adults at 104 million. Untreated cases drive 77 per cent productivity drops and 13 extra sick days a year per worker, measured against global benchmarks applied to India’s labour force.
The conference was chaired by Dr Vikas Agrawal, widely described as the father of sleep surgery in India. Justice Chandrachud inaugurated it through video conference. Padma Shri Milind Kirtane, Padma Shri Mohan Kameswaran and ISSS president Dr Maria Suurna were also present.
How sleep apnea eats into productivity
The cost estimate builds on India’s 1.4 billion population and its working-age demographics. Extrapolating to more than 100 million cases, the lifetime productivity loss per person, in wages foregone and absenteeism, alone totals Rs 1-2 lakh crore a year. Add the lifetime costs of cardiovascular disease and other non-communicable conditions, and the figure rises further.
A 77 per cent productivity drop among untreated cases makes it a workplace problem as much as a medical one. Workers show up but function at a fraction of capacity, and take nearly two extra weeks of sick leave a year. For an economy as large as India’s, the compounding effect across millions of workers is enormous.
Most of this damage is invisible to employers. The disorder goes undiagnosed in the majority of cases, and many sufferers attribute their daytime fatigue to long hours or stress. The conference heard that the disorder’s true cost only becomes visible when its downstream effects are added up.
Screening is cheap compared with the losses. A sleep study can identify the disorder in a single night, and treatment ranges from lifestyle changes and breathing devices to surgery. The conference heard that catching cases early would cost a fraction of the Rs 2-3 lakh crore now leaking out of the economy each year.
Sleep apnea on the roads and in hospitals
Forty per cent of India’s road accidents are tied to poor sleep, the conference heard. Drowsy driving kills in ways that are rarely recorded as the toll of a sleep disorder, and the estimate puts the road-safety angle of sleep apnea among its most urgent consequences.
Medical residents working 80-hour weeks show error rates that mimic drunk driving, the conference was told. Pilots and drivers compound the risk of chain-reaction failures, with the 2023 Mumbai crane collapse, in which six people died, cited as an example of how fatigue can turn deadly.
Hospitals carry their own share of the burden. Patients with the untreated disorder face higher risks around surgery and in intensive care, and their longer recovery times add to bed occupancy and treatment costs.
The sleep apnea surgery insurance question
The consensus at the conference was that much of the loss is salvageable if insurance covered all modalities of sleep apnea surgery. Dr Agrawal said the disorder is fully treatable, and that awareness is the missing link between patients and a cure.
"It is not just the economic cost. It is also the quality of life cost of sleep apnea," Dr Agrawal said, adding that nose block, snoring and sleep apnea are life threatening if not treated and should not be ignored. He said modern techniques such as in-clinic CT scans, sleep studies and sleep endoscopy allow precise identification of the problem, and described the procedure as a day-care one that is painless, bloodless and child friendly.
Insurance remains the bottleneck. Surgery for sleep apnea is available, but out-of-pocket costs keep it beyond the reach of many patients who need it. Covering all modalities of the procedure under insurance, the conference concluded, would turn a recoverable economic loss into treated patients and restored productivity.
The conference consensus was that insurance coverage for all modalities of surgery could salvage much of the estimated Rs 2-3 lakh crore annual loss.