Measuring Sleep: the Role of BMI, Neck Circumference and Sex in the Severity of Obstructive Sleep Apnea
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Abstract
Introduction: Obstructive sleep apnea (OSA) is a respiratory disorder associated with cardiovascular, metabolic complications and impairment of the quality of life. Body mass index (BMI), neck circumference (WC) and sex have been directly related to the risk and severity of the disease. However, in the Dominican Republic there is little information describing these associations in its population.
Objective: To evaluate the relationship between BMI, CC and sex with OSA severity as determined by the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI).
Methods: A cross-sectional study was conducted in adults with suspected OSA, evaluated with home polysomnography. Sociodemographic, anthropometric data and sleep parameters were collected. Pearson correlation analysis and logistic regression models were used to determine associations between variables.
Results: The mean age of the participants was 54 years, predominantly male (68.8%), and severe OSA (39.1%). A moderate positive correlation was found between BMI and AHI at 3% (r=0.433, p<0.001) and 4% (r=0.419, p<0.001). CC showed a weaker positive correlation. For each unit increase in BMI, the risk of severe OSA increased by 12% (p<0.001). Sex differences were observed, with higher prevalence of severe OSA in men.
Conclusions: BMI constitutes a relevant predictor of severity in OSA, especially in its severe forms, in the Dominican population.
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References
Halani V. Obstructive Sleep Apnea (OSA). Medscape; 2025. [Internet]. [Consultado 22 May 2025]. Disponible en: https://emedicine.medscape.com/article/295807-overview
Zasadzinska-Stempniak K, Zajaczkiewicz H, Kukwa A. Prevalence of Obstructive Sleep Apnea in the Young Adult Population: A Systematic Review. J Clin Med 2024;13(5):1386. https://doi.org/10.3390/jcm13051386
Mayo Clinic Staff. Sleep apnea. Mayo Clinic; 2023. [Internet]. [Consultado 22 May 2025]. Disponible en: https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631
Faria A, Allen AH, Fox N, Ayas N, Laher I. The public health burden of obstructive sleep apnea. Sleep Sci 2021;14(3):257-265. https://doi.org/10.5935/1984-0063.20200111
Yayan J, Rasche K. A Systematic Review of Risk factors for Sleep Apnea. Prev Med Rep 2024;42:102750. https://doi.org/10.1016/j.pmedr.2024.102750
Fattal D, Hester S, Wendt L. Body weight and obstructive sleep apnea: a mathematical relationship between body mass index and apnea-hypopnea index in veterans. J Clin Sleep Med 2022;18(12):2723-2729. https://doi.org/10.5664/jcsm.10190
Amado Garzon SB, Muñoz-Velandia OM, Ruiz AJ, Hidalgo Martínez P, Otero L. Cut-off points of neck and waist circumference as predictors of obstructive sleep apnea in the Colombian population: a comparison with polysomnography. Sao Paulo Med J 2023;142(3):e2022415. https://doi.org/10.1590/1516-3180.2022.0415.r2.310523
Lloyd RM, Crawford T, Donald R, Gray DD, Healy WJ, Junna MR. Quality measure for screening for adult obstructive sleep apnea by primary care providers: 2024 update after measure maintenance. J Clin Sleep Med 2024;20(11):1819-1822. https://doi.org/10.5664/jcsm.11294.
Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K 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;13(3):479-504. https://doi.org/10.5664/jcsm.6506
World Health Organization (WHO). Obesity and overweight. 2025. [Internet]. [Consultado 22 May 2025]. Disponible en: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Epworth Sleepiness Scale. About the ESS. [Internet]. [Consultado 18 Ago 2025]. Disponible en: https://epworthsleepinessscale.com/about-the-ess/
American Academy of Sleep Medicine (AASM). Obstructive Sleep Apnea [Internet]. [Consultado 22 May 2025]. Disponible en: https://aasm.org/resources/factsheets/sleepapnea.pdf
Gharib A, Loza S. Correction: Factors affecting the severity of the apnea-hypopnea index: a retrospective study on 838 Egyptian patients diagnosed with obstructive sleep apnea. Egypt J Bronchol 2024;18(82).
Fabozzi A, Pasqualotto F, Laguardia M, Natuzzi PF, Capone R, Steffanina A et al. Gender differences in obstructive sleep apnea syndrome: a pilot study. Sleep Breath 2024;28(4):1645-50. https://doi.org/10.1007/s11325-024-03052-x
Asad F, Moin M, Ubedullah, Rehman SU, Rehman FU. Relationship of Neck Circumference and Obstructive Sleep Apnea: A Cross-sectional Study in Pakistani Population. J Pharm Res Int 2022;34(44A):47-53. https://doi.org/10.9734/jpri/2022/v34i44A36333
Messineo L, Bakker JP, Cronin J, Yee J, White DP. Obstructive sleep apnea and obesity: A review of epidemiology, pathophysiology and the effect of weight-loss treatments. Sleep Med Rev 2024;78:101996. https://doi.org/10.1016/j.smrv.2024.101996
Tan J, Chen W, Yu D, Peng T, Li C, Lv K. Artificial Intelligence Screening Tool for Obstructive Sleep Apnoea: A Study Based on Outpatients at a Sleep Medical Centre. Nat Sci Sleep 2025;17:425-34. https://doi.org/10.2147/NSS.S503124
Reddy S, Koul PA, Bhat MH, Shah S, Ganie MA. Comparison of clinical, biochemical, and polysomnographic parameters between obese and nonobese obstructive sleep apnea. Lung India 2022;39(3):261-6. https://doi.org/10.4103/lungindia.lungindia_699_21
Hsing SC, Chen CC, Huang SH, Huang YC, Chung RJ, Chung CH et al. Obese patients experience more severe OSA than non-obese patients. Medicine (Baltimore) 2022;101(41):e31039. https://doi.org/10.1097/md.0000000000031039
Patial K, Mishra HP, Pal G, Suvvari TK, Ghosh T, Mishra SS et al. Understanding the Association Between Obesity and Obstructive Sleep Apnea Syndrome: A Case-Control Study. Cureus 2023;15(9):e45843. https://doi.org/10.7759/cureus.45843