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The aim was to estimate the prevalence of OSA in S\u00e3o Paulo, Brazil, based on data from the S\u00e3o Paulo Epidemiologic Sleep Study (EPISONO) 4th edition. This was a cross\u2010sectional study with a probabilistic sample obtained through a 4\u2010stage cluster sampling method aiming to represent the population according to age (20\u201380\u2009years), gender and socio\u2010economic condition. Participants underwent in\u2010lab full\u2010night polysomnography and completed sleep\u2010related questionnaires. The diagnosis of OSA followed the most recent guidelines of the American Academy of Sleep Medicine. Prevalences were calculated and a multivariable logistic regression evaluated risk factors associated with OSA. The total sample included 769 individuals (452 women). The general adjusted prevalence of OSA was 37.12%, being higher in men (44.88%) than women (30.79%). Greater prevalence was observed in advanced age groups. Moderate and severe OSA affected 11.5% and 7.9% of the participants, respectively. Ageing, body mass index and being male were associated with a higher risk of OSA, especially in moderate\u2010to\u2010severe cases. The 4th edition of EPISONO found that more than one\u2010third of the population had OSA, reaching 45% in males. These results underscore the need for public health actions based on scalable prevention strategies and equitable access to OSA therapies.<\/jats:p>","DOI":"10.1111\/jsr.70255","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:22:05Z","timestamp":1769505725000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prevalence and Risk Factors for Obstructive Sleep Apnea in S\u00e3o Paulo: Findings From the 4th Edition of the\n                    <scp>EPISONO<\/scp>\n                    Study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3804-8865","authenticated-orcid":false,"given":"Sergio","family":"Tufik","sequence":"first","affiliation":[{"name":"Departamento de Psicobiologia Universidade Federal de S\u00e3o Paulo (UNIFESP)  S\u00e3o Paulo Brazil"},{"name":"Instituto do Sono Associa\u00e7\u00e3o Fundo de Incentivo \u00e0 Pesquisa (AFIP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0133-9036","authenticated-orcid":false,"given":"Allan Saj","family":"Porcacchia","sequence":"additional","affiliation":[{"name":"Departamento de Psicobiologia Universidade Federal de S\u00e3o Paulo (UNIFESP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0411-0111","authenticated-orcid":false,"given":"Gabriel Natan","family":"Pires","sequence":"additional","affiliation":[{"name":"Departamento de Psicobiologia Universidade Federal de S\u00e3o Paulo (UNIFESP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1894-6748","authenticated-orcid":false,"given":"Monica Levy","family":"Andersen","sequence":"additional","affiliation":[{"name":"Departamento de Psicobiologia Universidade Federal de S\u00e3o Paulo (UNIFESP)  S\u00e3o Paulo Brazil"},{"name":"Instituto do Sono Associa\u00e7\u00e3o Fundo de Incentivo \u00e0 Pesquisa (AFIP)  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"i","article-title":"Obesity: Preventing and Managing the Global Epidemic. 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