Integrated Clinical, Anthropometric, Cardiometabolic, and Autonomic Determinants of Obstructive Sleep Apnea Severity: A Cross-Sectional Study

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Background: Obstructive sleep apnea (OSA) is a heterogeneous sleep-related breathing disorder associated with obesity, cardiometabolic comorbidities, nocturnal hypoxemia, and cardiovascular autonomic dysfunction. Although these factors are individually associated with OSA severity, their combined clinical and physiological relationships remain incompletely characterized. This study aimed to provide an integrated assessment of the clinical, anthropometric, cardiometabolic, hypoxemic, and autonomic determinants of OSA severity in adults undergoing sleep evaluation. Methods: This hospital-based cross-sectional observational study included 84 adults with OSA who underwent overnight evaluation using a Deck Mount Level III Sleep Apnea Monitoring Device. Demographic and anthropometric characteristics, cardiometabolic comorbidities, respiratory indices, and nocturnal oxygenation parameters were assessed. OSA severity was classified according to the Apnea–Hypopnea Index (AHI) as mild (5–14.9 events/hour), moderate (15–29.9 events/hour), or severe (?30 events/hour). Cardiovascular autonomic function was evaluated using heart rate variability (HRV), Valsalva ratio, deep breathing expiratory-to-inspiratory (E:I) ratio, and orthostatic blood pressure response. Associations and correlations between OSA severity and clinical, hypoxemic, and autonomic parameters were assessed using appropriate statistical methods. Results: Among the 84 participants, 13 (15.5%) had mild, 32 (38.1%) moderate, and 39 (46.4%) severe OSA. The overall mean age was approximately 49 years, with a marked male predominance, and the mean BMI was approximately 31 kg/m². Increasing OSA severity was associated with higher BMI, greater AHI and ODI, and progressively impaired nocturnal oxygenation. Mean AHI increased from 10.2 ± 2.8 events/hour in mild OSA to 22.1 ± 4.5 events/hour in moderate and 46.8 ± 12.7 events/hour in severe OSA (p