0866 Prevalence of Obesity in Obstructive Sleep Apnea Within a Large Community-based Cohort of Middle-aged/Older Adults

Abstract Introduction Obesity is a well-known risk factor for obstructive sleep apnea (OSA), gaining interest due to the global rise in obesity and novel obesity drugs. The rationale behind this lies in the role of obesity in the pathophysiology of OSA. However, many OSA patients are non-obese, and the association between obesity and OSA may vary by age and sex. Past population studies largely reported the prevalence of OSA according to different obesity categories. In this study, we sought to determine the prevalence of obesity across different levels of OSA severity, age, and sex. Methods The analytic sample included individuals with OSA from the Sleep Heart Health Study (SHHS). OSA severity was quantified using the apnea-hypopnea index (AHI4; apneas plus hypopneas with at least 4% oxygen desaturation per hour). Individuals were stratified by the severity of OSA (mild: 5≤AHI4 15; moderate: 15≤AHI4 30; severe: AHI4≥30 events/hour), body mass index (BMI), age, and sex. Results A total of 2950 of 5749 participants in SHHS had OSA (AHI4≥5 events/hour; 1729/788/433 mild/moderate/severe). Of these, 40.6% were female; mean±SD age was 65.3±10.7 years; and median interquartile range BMI was 28.8 25.8; 32.3 kg/m2. For those with any OSA, 60.6% were non-obese (BMI 30 kg/m2) and 39.4% were obese (BMI≥30 kg/m2). Across OSA severities, 34.1% of mild, 42.6% of moderate and 54.3% of severe OSA were obese. A greater proportion of younger adults ( 65 years) with OSA were obese (48.3%) than older adults (≥65 years) with OSA (30.9%). In older adults 26.7% of mild, 34.5% of moderate and 40.3%of severe OSA were obese. Finally, a greater proportion of females with OSA were obese (43.6%) than males with OSA (36.5%). Conclusion The majority of middle-aged/older adults with OSA are non-obese. The association between obesity and OSA varies by age and sex, with a higher prevalence of obesity in younger adults and in females with OSA. Additional analyses of data from the Multi-Ethnic Study of Atherosclerosis, the Osteoporotic Fractures in Men study, and the HypnoLaus study are being conducted to establish the association between OSA and obesity within other community-based samples. Support (if any) NHLBI R01HL153874, R35HL135818 and unrestricted grant support from Apnimed.