The Association of Polysomnographic Variables with BMI, Gender, and Age in Sudanese Adults with Obstructive Sleep Apnea

Abstract

Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder characterized by repetitive upper airway collapse during sleep. This study examines the relationship between polysomnographic variables and body mass index (BMI), gender, and age in 251 Sudanese adults with OSA, a population that has been underrepresented in prior research. Using overnight polysomnography, OSA severity was classified based on the apnea-hypopnea index (AHI). Results revealed a significant positive correlation between BMI and key polysomnographic parameters, including AHI, arousal index, and desaturation index, while sleep efficiency was negatively correlated with BMI. Severely obese individuals (BMI ≥ 40 kg/m²) exhibited the highest AHI values (53.2 ± 36.3), with significant declines in sleep efficiency observed in obese participants. Age was negatively correlated with sleep efficiency, with older adults (≥65 years) showing the lowest values (74.9 ± 17.3). Gender differences were observed, with males exhibiting higher sleep efficiency (81.2 ± 15.6 vs. 75.6 ± 16.7, p = 0.010) and snoring intensity (29.0 ± 16.4 vs. 23.9 ± 13.8, p = 0.008), though AHI did not differ significantly between genders. This study provides novel insights into the multifactorial nature of OSA severity, highlighting the critical influence of BMI, age, and gender. However, the cross-sectional design limits causal inferences, and the omission of certain anthropometric measures, such as neck circumference and waist-to-hip ratio, may have influenced the findings. These results underscore the need for targeted interventions addressing obesity and age-related changes in sleep physiology, particularly in understudied populations such as Sudanese adults.