From the Guidelines
A BMI of 25 kg/m2 or higher places you at risk for Obstructive Sleep Apnea (OSA) 1.
Key Factors
- Obesity is a major risk factor for OSA, with 60-90% of patients with OSA presenting with a BMI greater than 30 kg/m2 1
- The relationship between weight gain and the development and worsening of OSA is well established 1
- Weight loss is recommended as an adjunctive therapeutic tool for managing OSA in patients who are overweight or obese 1
BMI Categories
- Overweight: BMI of 25.0-29.9 kg/m2 1
- Obesity: BMI of 30.0 kg/m2 or higher, which can be further subdivided into:
- Grade I obesity: BMI of 30.0-34.9 kg/m2
- Grade II obesity: BMI of 35.0-39.9 kg/m2
- Grade III obesity: BMI of 40.0 kg/m2 or higher 1
From the Research
BMI and Obstructive Sleep Apnea (OSA) Risk
- A BMI of 30 or higher is considered a risk factor for OSA, as obesity is a major contributor to the development of the condition 2, 3, 4.
- Studies have shown that higher BMI values are correlated with an increased severity of OSA, as well as a higher apnea-hypopnea index (AHI) 2, 3.
- A BMI cutoff value of 33 has been suggested as a threshold for screening OSA in adults, with patients having a BMI above 33 being at higher risk for sleep-disordered breathing 3.
- In women, a BMI of 27.75 or higher has been identified as a cutoff value for OSA, while in men, a BMI of 27.75 or higher is also considered a risk factor 5.
- Normal BMI (less than 25) has been found to have a high negative predictive value for moderate or severe OSA in the lateral sleeping position, suggesting that patients with a normal BMI may be less likely to have OSA 6.
BMI Categories and OSA Risk
- The following BMI categories have been associated with an increased risk of OSA:
- Overweight (25 ≤ BMI < 30): increased risk of OSA, particularly in the lateral sleeping position 2, 6.
- Obese (30 ≤ BMI < 35): higher risk of OSA, with increased AHI and severity of sleep-disordered breathing 2, 3.
- Severely obese (35 ≤ BMI < 40): significantly higher risk of OSA, with increased AHI and severity of sleep-disordered breathing 2, 3.
- Morbidly obese (BMI ≥ 40): extremely high risk of OSA, with severe sleep-disordered breathing and increased AHI 2, 3.
Sex Differences in BMI and OSA Risk
- Studies have found that the relationship between BMI and OSA risk differs between men and women, with women being more likely to experience OSA at lower BMI levels than men 4, 5.
- In women, a higher BMI is associated with an increased risk of OSA, particularly in the lateral sleeping position 4.
- In men, a higher BMI is also associated with an increased risk of OSA, but the relationship is more complex and influenced by other factors such as upper airway stiffness and circulatory delay 4.