Age-dependent association of body mass index and obstructive sleep apnea severity in women
6 affiliations
- 1UCI Health Sleep Disorders Center, University of California, 20350 SW Birch Street, Suite 100, CA 92660 Newport Beach, United States of America
- 2Department of Psychiatry and Human Behavior, University of California, Irvine, CA United States of America
- 3Department of Psychiatry, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
- 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- 5The Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA United States of America
- 6Carle BroMenn Medical Center, Bloomington, IL United States of America
Abstract
Purpose: Obstructive sleep apnea (OSA) is influenced by body mass index (BMI), age, and sex. Although obesity is a major risk factor for OSA, the strength of the association between BMI and OSA severity may vary across demographic groups. We investigated whether age modifies the relationship between BMI and OSA severity in men and women.
Methods: We performed a cross-sectional analysis of adults who underwent polysomnography at a university-based sleep laboratory. The relationship between BMI and apnea-hypopnea index (AHI), including supine AHI, was evaluated. Participants were categorized into younger and older age groups (< 55 vs. ≥55 years). Linear regression models with interaction terms were used to assess whether age modified the association between BMI and OSA severity.
Results: A total of 752 participants were included. The associations of BMI categories with normalized AHI and normalized supine AHI were weaker in older women than in younger women (P for interaction = 0.03 and 0.02, respectively), whereas no significant interaction by age group was observed in men. Results were similar for log-transformed BMI (P for interaction = 0.03 for both in women). However, the three-way interaction among BMI, age group, and sex was not significant.
Conclusions: The association between BMI and OSA severity was attenuated in women aged 55 years or older compared with younger women. Because a sex difference in this age-related attenuation was not statistically confirmed, these findings should be interpreted with caution. They suggest that BMI alone may be a less informative indicator of OSA severity in older women.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11325-026-03849-y.
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BibTeX
@article{cho2026agedependent,
title = {{Age-dependent association of body mass index and obstructive sleep apnea severity in women}},
author = {Unjung Cho and Chang-Hoon Lee and Mark Dyken and Rachel Immen and KyoungBin Im},
journal = {Sleep \& Breathing = Schlaf \& Atmung},
year = {2026},
month = oct,
doi = {10.1007/s11325-026-03849-y},
url = {https://doi.org/10.1007/s11325-026-03849-y},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Age-dependent association of body mass index and obstructive sleep apnea severity in women
AU - Unjung Cho
AU - Chang-Hoon Lee
AU - Mark Dyken
AU - Rachel Immen
AU - KyoungBin Im
PY - 2026
DA - 2026/10/31
JO - Sleep & Breathing = Schlaf & Atmung
DO - 10.1007/s11325-026-03849-y
UR - https://doi.org/10.1007/s11325-026-03849-y
AB - Purpose: Obstructive sleep apnea (OSA) is influenced by body mass index (BMI), age, and sex. Although obesity is a major risk factor for OSA, the strength of the association between BMI and OSA severity may vary across demographic groups. We investigated whether age modifies the relationship between BMI and OSA severity in men and women. Methods: We performed a cross-sectional analysis of adults who underwent polysomnography at a university-based sleep laboratory. The relationship between BMI and apnea-hypopnea index (AHI), including supine AHI, was evaluated. Participants were categorized into younger and older age groups (< 55 vs. ≥55 years). Linear regression models with interaction terms were used to assess whether age modified the association between BMI and OSA severity. Results: A total of 752 participants were included. The associations of BMI categories with normalized AHI and normalized supine AHI were weaker in older women than in younger women (P for interaction = 0.03 and 0.02, respectively), whereas no significant interaction by age group was observed in men. Results were similar for log-transformed BMI (P for interaction = 0.03 for both in women). However, the three-way interaction among BMI, age group, and sex was not significant. Conclusions: The association between BMI and OSA severity was attenuated in women aged 55 years or older compared with younger women. Because a sex difference in this age-related attenuation was not statistically confirmed, these findings should be interpreted with caution. They suggest that BMI alone may be a less informative indicator of OSA severity in older women. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11325-026-03849-y.
SN - 1520-9512
SN - 1522-1709
ER -