Clinical and Polysomnographic Differences in Obese and Nonobese Patients with Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is characterized by repeated episodes of upper airway obstruction during sleep, resulting in fragmented sleep and associated health risks.

This retrospective study investigated the clinical and polysomnographic differences between obese and nonobese patients diagnosed with OSA.

A total of 210 patients underwent a Level 3 sleep study. Based on the apnea-hypopnea index (AHI), 180 patients with OSA were included in the study. Patients were categorized as obese (body mass index [BMI] ≥27.5) or nonobese (BMI <27.5). Clinical parameters, AHI, oxygen desaturation index (ODI), Epworth Sleepiness Scale (ESS), neck circumference, age, and gender were compared.

Obese patients had significantly higher AHI, ODI, ESS scores, and neck circumference than nonobese patients ( P < 0.05). Gender was associated with the severity of OSA only in the obese group. Age was not significantly associated with OSA severity in either group.

Obesity is strongly associated with more severe OSA and anatomical risk factors. Nonobese OSA patients also exhibited clinically relevant symptoms, suggesting distinct nonanatomical mechanisms.

This study concludes that while obesity is linked to more severe OSA due to anatomical factors, non-obese patients also experience significant disease, highlighting the importance of individualized, phenotype-driven management strategies.