Impact of Anthropometric Indices on Residual Obstructive Sleep Apnea and Pressure Requirements During APAP Therapy APAP Tedavisi Sırasında Antropometrik İndekslerin Rezidüel Obstrüktif Uyku Apnesi ve Basınç Gereksinimleri Üzerine Etkisi

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ÇELİK B., GÜL F., Topal A., BULUT K. Ş., Şerifler S., Babadelez M. A.

Journal of Ear Nose Throat and Head Neck Surgery, cilt.34, sa.3, ss.184-193, 2026 (Scopus, TRDizin)

Özet

Objective: This study investigated the predictive value of conventional anthropometric indices, such as body mass index (BMI), and novel indices, including the Body Roundness Index (BRI) and waist-to-neck ratio (WNR), for residual obstructive sleep apnea (OSA) and therapeutic pressure requirements during auto-adjusting positive airway pressure (APAP) therapy in patients with moderate-to-severe OSA. Material and Methods: Data from 58 adults with moderate-to-severe OSA who were switched to APAP due to continuous PAP intolerance were retrospectively reviewed. Anthropometric measurements (height, weight, waist, and neck circumference) were obtained, and BRI and WNR were calculated. Residual OSA was defined as a post-treatment Apnea-Hypopnea Index (AHI) ≥5 events/hour. Patients were classified according to residual OSA status, and group differences in anthropometric parameters and pressure requirements were analyzed. Logistic regression and receiver operating characteristic analyses were performed. Results: APAP therapy reduced mean AHI by 91.2%; however, residual OSA persisted in 36.2% of patients (n=21), who required significantly higher minimum (p<0.001), maximum (p<0.001), and mean (p<0.001) therapeutic pressures. Among all anthropometric indices, only BMI was significantly higher in patients with residual OSA (34.18 vs. 30.84 kg/m2, p=0.045). BMI independently predicted residual OSA (area under the curve=0.686; cutoff=31.25 kg/m2), whereas BRI and WNR showed no significant predictive value. Conclusion: BMI is a simple and accessible anthropometric marker that modestly predicts residual OSA and higher APAP pressure requirements, outperforming more complex indices such as BRI and WNR. These findings suggest that overall adiposity has a greater clinical impact on APAP treatment outcomes than regional fat distribution.