The relationship between obesity and obstructive sleep apnea in four community-based cohorts: an individual participant data meta-analysis of 12,860 adults.
Neda Esmaeili, Laura Gell, Théo Imler, Mohammadreza Hajipour, Luigi Taranto-Montemurro, Ludovico Messineo, Katie L Stone, Scott A Sands, Najib Ayas, John Yee, John Cronin, Raphael Heinzer, Andrew Wellman, Susan Redline, Ali Azarbarzin
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引用次数: 0
Abstract
Background: Obesity is a well-established risk factor for obstructive sleep apnea (OSA). We assessed the reciprocal prevalence of obesity and OSA and how it varies by age and sex.
Methods: Following a systematic review through March 27, 2025, the final sample included four community-based cohort studies in the US and Switzerland. OSA severity was quantified using the apnea-hypopnea index (AHI, all apneas plus hypopneas with ≥4% oxygen desaturation/hour). Random effects individual participant data (IPD) meta-analyses estimated prevalences. Logistic regression compared odds of OSA across weight groups.
Findings: Among 12,860 adults (mean ± SD age: 66.6 ± 7.3 years), 7222 (56.2%) had OSA (AHI ≥5 events/h) and 3309 (25.7%) had obesity (BMI ≥30 kg/m2). IPD meta-analysis showed 31.5% [95% CI: 16.8-48.5] of individuals with OSA had obesity and 44.4% [36.5-52.5] had overweight status (25 ≤ BMI < 30). Among subgroups of individuals with obesity and overweight, 74.3% [63.8-83.5] and 59.8% [46.5-75.7] had any OSA, respectively. Obesity was higher in females than males with OSA, and in younger (<65 years) vs. older individuals. Odds ratios for OSA in subgroups of individuals with overweight and obesity compared to BMI <25 kg/m2 were 2.18 [1.73-2.76] and 4.84 [3.09-6.00], respectively.
Interpretation: Our analyses show that most adults with OSA do not have obesity, with 44.4% having overweight and 23.5% having normal weight or underweight. Obesity was more prevalent among females compared to males and in younger individuals (<65 years) compared to older individuals with OSA. Recognizing OSA is not exclusive to obesity highlights the need for personalized treatment plans.
Funding: American Academy of Sleep Medicine, National Heart, Lung, and Blood Institute, and Apnimed.
期刊介绍：
eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.
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