Esmaeili Neda, Gell Laura, Imler Théo, Hajipour Mohammadreza, Taranto-Montemurro Luigi, Messineo Ludovico, Stone Katie L, Sands Scott A, Ayas Najib, Yee John, Cronin John, Heinzer Raphael, Wellman Andrew, Redline Susan, Azarbarzin Ali
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Apnimed, USA.
EClinicalMedicine. 2025 Apr 23;83:103221. doi: 10.1016/j.eclinm.2025.103221. eCollection 2025 May.
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.
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.
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/m). 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/m were 2.18 [1.73-2.76] and 4.84 [3.09-6.00], respectively.
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.
American Academy of Sleep Medicine, National Heart, Lung, and Blood Institute, and Apnimed.
肥胖是阻塞性睡眠呼吸暂停（OSA）公认的危险因素。我们评估了肥胖与OSA的相互患病率及其在年龄和性别上的差异。
在截至2025年3月27日的系统评价之后，最终样本包括美国和瑞士的四项基于社区的队列研究。使用呼吸暂停低通气指数（AHI，所有呼吸暂停加低通气且氧饱和度下降≥4%/小时）对OSA严重程度进行量化。随机效应个体参与者数据（IPD）荟萃分析估计患病率。逻辑回归比较了不同体重组中OSA的比值比。
在12860名成年人（平均±标准差年龄：66.6±7.3岁）中，7222人（56.2%）患有OSA（AHI≥5次/小时），3309人（25.7%）患有肥胖症（BMI≥30kg/m²）。IPD荟萃分析显示，31.5%[95%置信区间：16.8 - 48.5]的OSA患者患有肥胖症，44.4%[36.5 - 52.5]的患者超重（2
