Impact of Body Mass Index on OSA Severity: A Tunisian Single-Center Study

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Introduction: Obesity is a major risk factor for obstructive sleep apnea (OSA). The relationship between BMI and OSA severity needs better characterization. Objective: To analyze the relationship between BMI and OSA severity in a Tunisian population. Methods: Single-center retrospective study including 70 patients with confirmed OSA between 2013-2023. Anthropometric data, BMI, apnea-hypopnea index (AHI), and comorbidities were analyzed. Results: A total of 70 patients were included (54.5% male, mean age 44.09±11.73 years). BMI distribution showed: 25% overweight, 45.3% grade 1 obesity, 18.8% grade 2, and 10.9% grade 3, with mean BMI of 33.94±6.2 kg/m². Mean AHI was 48.14/h (range 16-93.9), with 97.1% severe OSA. Clinical presentation included snoring (95.7%), daytime sleepiness (71.4%), and witnessed apneas (54.3%). Mean Epworth score was 12.76±4.3. Associated comorbidities included hypertension (25.7%), diabetes (17.1%), and dyslipidemia (7.1%). Higher BMI categories were associated with higher AHI scores (p<0.05) and more frequent nocturnal symptoms. CPAP treatment was indicated in 97.1% of cases, with concurrent weight management recommended in 50%. Obesity was significantly associated with higher treatment pressure requirements and more frequent therapy-related side effects. Conclusion: This study confirms obesity’s importance in OSA severity and highlights the necessity of concurrent weight management with CPAP treatment.

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