Obstructive Sleep Apnea Hypopnea Syndrome (OSAS) in a French overseas territory: a cross-sectional study in Martinique

Background Obstructive sleep apnea syndrome (OSAS) remains widely underdiagnosed and undertreated. In Martinique, a French overseas territory, the prevalence of continuous positive airway pressure (CPAP) therapy is the highest in France, suggesting a substantial burden of moderate-to-severe disease. The objective of this study was to assess the prevalence of OSAS and to identify factors associated with moderate-to-severe OSAS in this population. Methods We conducted an observational study including 213 consecutive adults evaluated at the Sleep Unit of the University Hospital of Martinique between July 2024 and July 2025. Moderate-to-severe OSAS was defined in symptomatic patients by an apnea–hypopnea index (AHI) ≥ 15 events/hour. Results OSAS (AHI ≥ 5 events/hour) was diagnosed in 189 patients, corresponding to a prevalence of 88.7% (95% CI 84.4–93.0%). Moderate-to-severe disease was observed in 61.3% of cases. Although women accounted for 65% of referrals, men more frequently presented with moderate-to-severe OSAS. Insomnia symptoms were reported by 62% of patients, and comorbid insomnia and sleep apnea (COMISA) was identified in 57.7% of those with confirmed OSAS. In multivariable analysis, male sex, increased neck circumference, snoring, nocturia, and witnessed apneas were independently associated with moderate-to-severe OSAS. Conclusion This study demonstrates a very high hospital-based prevalence of OSAS in Martinique and reveals a marked gender-related diagnostic gap. Simple clinical markers may facilitate earlier identification of patients at high risk for moderate-to-severe OSAS.