Comorbidities and anthropometric parameters in obstructive sleep apnea syndrome: a phenotype-based study.

Purpose: Obstructive Sleep Apnea Syndrome (OSAS) is a heterogeneous syndrome and shows different phenotypic, clinical and physiopathological features. The aim of this study was to examine the relationships between OSAS phenotypes and comorbidities and anthropometric measurements and to identify OSAS phenotypes that should be referred for early diagnosis and treatment.

Materials and methods: We retrospectively reviewed 600 patients who underwent polysomnography (PSG) in our sleep center. Seven phenotypes were defined as Simple Snoring (SS)-Control, Mild, Moderate and Severe OSAS, Rem Dependent OSAS (RDO), Position Dependent OSAS (PDO) and Rem+Position dependent OSAS (R+PDO). Demographic data, anthropometric measurements and comorbid diseases of the patients were obtained retrospectively from their files. OSAS phenotypes were compared with comorbidities and anthropometric measurements.

Results: Severe OSAS was the most common phenotype. Oxygen desaturation index (ODI) and anthropometric measurements showed significant differences between phenotypes (p < .001). Hypertension (HT) (43.7%) and ischemic heart disease (CHD) (14.2%) were the most common comorbidities and were most commonly associated with severe OSAS. In logistic regression analysis, neck circumference (NC) and body mass index (BMI) were the anthropometric measures that predicted OSAS phenotypes. NC and BMI predicted severe OSAS, NC predicted PDO and R+PDO, and BMI predicted RDO.

Conclusion: This study revealed that OSAS phenotypes exhibit different clinical and anthropometric characteristics and differ in comorbidity risks. HT was found to be higher in severe OSAS, moderate OSAS and R+PDO, and CHD was higher in severe OSAS and RDO. Our study emphasized the importance of phenotypic characteristics as well as AHI in the management of comorbidities in OSAS.