The Cardiometabolic Index (CMI) is associated with an increased risk of obstructive sleep apnea: a population-based study

Q: What are the key findings of this study?

Higher Cardiometabolic Index (CMI) is associated with increased risk of obstructive sleep apnea, with an OR of 1.272 for the highest versus lowest CMI groups (P < 0.001).

Q: What does this research mean for the field?

Higher Cardiometabolic Index (CMI) is associated with increased risk of obstructive sleep apnea, with an OR of 1.272 for the highest versus lowest CMI groups (P < 0.001). Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the relationship between the Cardiometabolic Index (CMI) and the risk of obstructive sleep apnea (OSA) across a large-scale population cohort.

Xin Chen; Yueyu Zhang; Yang Wang; Yi Tang; Kangrui Zhang; Jing Wu

doi:10.1186/s40001-025-03687-w

December 20, 2025European journal of medical researchOpen Access

The Cardiometabolic Index (CMI) is associated with an increased risk of obstructive sleep apnea: a population-based study

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Key result

Higher Cardiometabolic Index is linked to ~27% greater risk of obstructive sleep apnea.

P < 0.001

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Why the study?

Is an elevated Cardiometabolic Index (CMI) associated with an increased risk of obstructive sleep apnea (OSA) in adults?

Key Points

To evaluate the relationship between the Cardiometabolic Index (CMI) and the risk of obstructive sleep apnea (OSA) across a large-scale population cohort.
Analyzed cross-sectional data from 39,722 participants in the 2005–2008 and 2015–2018 cycles of the National Health and Nutrition Examination Survey (NHANES).
Identified OSA using self-reported symptoms including daytime sleepiness and nocturnal choking or snoring rather than polysomnography.
Assessed associations using multivariable logistic regression, threshold-dependent segmented regression, and propensity score matching (PSM).
Continuous CMI showed a significant association with OSA risk in Model 3 (OR = 1.014, P = 0.024), with the highest quartile having greater risk than the lowest quartile (OR = 1.272, P < 0.001).
Segmented regression identified an inverted L-shaped threshold at CMI 2.03, showing an increased risk when CMI < 2.03 (OR = 1.50, P < 0.001) that remained elevated after PSM (OR = 1.174, P = 0.018).
Subgroup analyses revealed stronger associations between CMI and OSA risk in females, younger participants, and individuals without hypertension or stroke.

Structured PICO

Is an elevated Cardiometabolic Index (CMI) associated with an increased risk of obstructive sleep apnea (OSA) in adults?

P

Population

14,986 adults (aged ≥ 20 years) from the 2005–2008 and 2015–2018 cycles of the National Health and Nutrition Examination Survey (NHANES), mean age 49.56, 49.83% female, United States.

I

Intervention

Cardiometabolic Index (CMI) as an exposure variable

C

Comparator

Lowest CMI quartile (Q1)

O

Outcome

Risk of obstructive sleep apnea (OSA) defined by self-reported symptomspatient reported

Limitations

Use of self-reported symptoms to diagnose OSA has significant methodological limitations
Insufficient diagnostic sensitivity due to biases in symptom perception
False-positive interference caused by overlapping comorbid symptoms
Reliance on participants' retrospective memory

Implication

The Cardiometabolic Index (CMI) demonstrates a non-linear positive association with obstructive sleep apnea risk, suggesting its potential utility as a convenient screening indicator for high-risk populations.

Abstract

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Cite This Study

Chen et al. (2025) studied this question. Higher Cardiometabolic Index (CMI) is associated with increased risk of obstructive sleep apnea, with an OR of 1.272 for the highest versus lowest CMI groups (P < 0.001).

synapsesocial.com/papers/6963223891e05aa366cb8d3e https://doi.org/10.1186/s40001-025-03687-w

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The Cardiometabolic Index (CMI) is associated with an increased risk of obstructive sleep apnea: a population-based study

Figures

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

The Cardiometabolic Index (CMI) is associated with an increased risk of obstructive sleep apnea: a population-based study

Figures

Key Points

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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