Polysomnographic characteristics of obstructive sleep apnea in obese patients

The available scientific research does not sufficiently describe the specific polysomnographic (PSG) characteristics of obstructive sleep apnea (OSA) in obese patients. The aim was to determine the clinical and PSG characteristics of OSA in obese patients. Methods. The study included retrospective analysis of medical histories, assessment of the frequency of concomitant and previous diseases, and analysis of PSG results (Сomet PSG, Grass Technologies, USA). Results. The study included 2 groups of patients: the main group with OSA and BMI > 30 kg/m2 (n = 100) and the control group with OSA and BMI 18 – 25 kg/m2 (n = 44). In the main group, the Charlson comorbidity index (p = 0.012), the likelihood of hypertension (OR 6.4 (95% CI 2.9 – 14.2)), type 2 diabetes mellitus or impaired glucose tolerance (OR 29.9 (95% CI 3.9 – 225.7)), dyslipidemia (OR 2.4 (95% CI 1.1 – 4.9)), and ahistory of pneumonia (OR 3.2 (95% CI 1.1 – 8.9)) were higher than in control group. The PSG analysis revealed that severe OSA was detected in mostpatients (52%) of the main group and in none of the patients in the control group. Duration of SpO₂ < 90% was longer in the main group (42.4 min), than in the control group (0.9 min). The apnea-hypopnea index was increased in the REM sleep stage and in supine position in the main group. Duration of sleep stages was different: stage 1 was longer in the main group and stage 2 was longer in the control group. There were no differences in REM and stage 3. Obese patients had more frequent arousals, due to episodes of apnea and hypopnea and snoring. Conclusion. Our study identified certain characteristics of PSG in OSA and obesity, which may explain the higher incidence of concomitant severe diseases that may be associated with cardio-renal-metabolic syndrome.

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