An individual participant data meta-analysis of 12,860 adults demonstrated that only 31.5% of individuals with obstructive sleep apnea had obesity, while 44.4% had overweight and 23.5% had normal weight.
Meta-Analysis (n=12,860)
Yes
Most adults with obstructive sleep apnea do not have obesity, highlighting the need for personalized screening and treatment plans beyond weight management.
Background: 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. Methods: 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. Findings: were 2.18 1.73-2.76 and 4.84 3.09-6.00, respectively. Interpretation: 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. Funding: American Academy of Sleep Medicine, National Heart, Lung, and Blood Institute, and Apnimed.
Esmaeili et al. (2025) conducted a meta-analysis in Obstructive sleep apnea (OSA) and obesity (n=12,860). Obesity vs. Overweight or normal/underweight was evaluated on Prevalence of obesity in individuals with OSA (95% CI 16.8-48.5). An individual participant data meta-analysis of 12,860 adults demonstrated that only 31.5% of individuals with obstructive sleep apnea had obesity, while 44.4% had overweight and 23.5% had normal weight.