Sleep is the foundation of health.

We spend a lot of time talking about nutrition and exercise. But one important topic still gets too little attention in conversations about our overall health: How are you sleeping? Do you wake up feeling well rested? The answers to those questions can open the door to understanding how you sleep, and subsequently, potential impact on your overall health.

Poor sleep can negatively impact mood and mental health, increase risk of obesity and cardiovascular disease, and worsen insulin resistance in people with type two diabetes.[1] Research also links consistently sleeping six hours or less in midlife and later life to about a 30% higher risk of dementia.[2]

More people are starting to understand that sleep matters for long term health. But knowing and doing something about it are two different things. Resmed’s 2026 Global Sleep Survey found that 66% of respondents would consult a healthcare provider for persistent sleep issues, but only 23% have. New CDC data reveals nearly 3 in 4 U.S. adults reported feeling very tired or exhausted at least some days over the previous three months.

This information is telling, and we have the opportunity to do something about it on a broad scale.

If we want a healthier country, sleep needs to be recognized as a foundational part of preventative and overall health. Additionally, both patients and providers need a clear path from awareness to diagnosis, treatment, and ongoing care. And when a safe, effective, and clinically appropriate treatment is right for an eligible patient, coverage policies need to support timely access.

This requires recognizing sleep as part of the broader health picture. Sleep should not be considered in isolation from other chronic conditions. And healthcare providers need the tools and training to talk about sleep with patients and recognize when poor sleep may signal something more.

Obstructive sleep apnea (OSA), the most common form of sleep apnea, offers a powerful example of why this matters. OSA is a common condition in which breathing repeatedly pauses or becomes shallow during sleep. More than 50 million Americans have OSA[3] and an estimated 80% of cases remain undiagnosed.[4] By 2050, that number is expected to grow to nearly 77 million.[3] Untreated sleep apnea can increase the risk of heart disease, diabetes, and stroke. [1]

Data also tells us that the gold standard treatment for OSA, continuous positive airway pressure (CPAP) therapy, works.[5] Research shows that people with sleep apnea who used CPAP to treat their OSA had a 37% lower risk of dying and a 55% lower risk of heart-related death.[6]

Yet many patients live with the symptoms of OSA and never receive a diagnosis. Others may receive a diagnosis but defer or stop treatment because they lack support getting to the right solution. CPAP therapy is the most common first-line treatment for OSA and works well for most people, but there are barriers in the pathway to care, and success often depends on mask fit, coaching and follow up.

Medicare and many private payers already recognize the importance of treating sleep apnea by covering established therapies like CPAP, but coverage requirements could allow clinically appropriate flexibility. Medicare requires CPAP use of at least four hours a night on 70% of nights during a 30-day period in the first three months.[7] In a study of more than 132,000 patients, 51% did not meet that requirement, yet 36% were still using CPAP a year later. [8]

The finding suggests that early difficulty with treatment doesn’t necessarily mean a patient won’t succeed over time with the right support. Coverage rules could take this into account to ensure access to evidence-based treatments as well as ongoing support for sleep conditions.

Access can also be hard in practical ways. Added approvals, paperwork and supplier requirements can delay care. Someone who struggles with one treatment may benefit from another evidence-based option. And someone who lives far from a sleep lab may be a candidate for clinically appropriate home testing.

Sleep belongs in broader conversation about prevention and chronic disease. If we want a healthier country, we need to make it easier for people to move from awareness to appropriate evaluation, diagnosis, and evidence-based care. That leaves both patients and policymakers with practical steps to consider.

What people can do:

• Don’t normalize poor sleep. If you regularly wake up feeling unrested, snore loudly, gasp at night, or have sleep issues that affect how you feel or function during the day, talk to a healthcare provider.

• Start with the basics. Keep a consistent schedule, wind down before bed, and set up a sleep-friendly room.
• Expect care to be personal. For some treatments, such as a CPAP for sleep apnea, comfort, mask fit, coaching, and follow-up matter. If one treatment is not working, ask your healthcare provider about adjustments or alternatives.
• Use technology as support, not a substitute. Consumer health wearables that track sleep can be helpful tools for building awareness and identifying changes over time. When those signals raise concerns, they can also be a prompt to discuss sleep with a healthcare provider.
• Check coverage early. Before you start treatment, ask what sleep study, paperwork, supplier, or follow-up requirements apply to help achieve timely care.

What policymakers can do:

• Make sleep part of primary care and prevention. Integrate sleep health into chronic disease prevention and management, especially for people living with heart disease, diabetes, or obesity.
• Build the evidence. Use NIH’s existing sleep research infrastructure and refresh the NIH Sleep Research Plan so priorities reflect the latest science and real-world evidence.
• Review Medicare rules, keeping program integrity in mind. Make sure coverage requirements, such as CPAP use requirements, give patients enough time, coaching, and support to succeed while confirming continued coverage remains medically necessary and appropriate.
• Keep alternatives available for appropriate patients. Support evidence-based options for patients who meet clinical criteria when one treatment option doesn’t work.
• Let evidence guide access. Support clinically appropriate use of home testing, remote monitoring, and other safe, effective sleep technologies as evidence develops.

Nunez is chief medical officer of Resmed, the leading health technology company focused on sleep, breathing, and care delivered in the home. Our mission is to create life-changing health technologies that people love. Every day, that work helps more people sleep better, breathe better and live longer, happier, and healthier lives. 

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[1] Chaput et al. Routinely assessing patients’ sleep health is time well spent. Prev Med Rep. 2019.

[2] Sabia S, Fayosse A, Dumurgier J, et al. Association of sleep duration in middle and old age with incidence of dementia. Nat Commun. 2021;12:2289. doi:10.1038/s41467-021-22354-2.

[3] Benjafield AV, Ayas NT, Eastwood PR, Heinzer R, Ip MSM, Morrell MJ, Nunez CM, Patel SR, Penzel T, Pépin JL, Peppard PE, Sinha S, Tufik S, Valentine K, Malhotra A. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019.

[4] Kapur VK, Auckley DH, Chowdhuri S, et al. Clinical Practice. Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017.

[5] Patil SP et al. J Clin Sleep Med. 2019 Feb 15;15(2):301-334.

[6] Benjafield AV, Pépin JL, Cistulli PA, et al. Positive airway pressure therapy and all-cause and cardiovascular mortality in people with obstructive sleep apnoea: a systematic review and meta-analysis of randomised controlled trials and confounder-adjusted, non-randomised controlled studies. Lancet Respir Med. 2025;13:403-413. doi:10.1016/S2213-2600(25)00002-5.

[7] Centers for Medicare & Medicaid Services. Local Coverage Determination L33718, Medicare Coverage Database. https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=33718

[8] Hwang D, et al. Presented at: ATS 2026 International Conference; May 2026; Orlando, FL. Kaiser Permanente Southern California. Lead author Dennis Hwang, MD.