Body composition and hydration status were significantly associated with sleep architecture and AHI, supporting a personalized approach to OSA management emphasizing not only weight control but also muscle preservation and fluid balance optimization.
Key Findings
Results
Fat percentage and fat mass were positively associated with increasing apnea-hypopnea index (AHI) in adults with OSA.
Cross-sectional study of 5,381 adults undergoing overnight polysomnography and bioimpedance analysis
Multivariable linear regression adjusted for age, sex, and BMI was used
A unit increase in fat percentage (FATP) and fat mass (FATM) were associated with increasing AHI
Stratified analyses revealed stronger adiposity-AHI associations in females and individuals with obesity
Age-specific analyses showed stronger adiposity-AHI associations in younger adults, with these associations tending to attenuate with age
Results
Bone mass and fat-free mass were negatively associated with AHI, particularly in younger adults.
Increases in bone mass and fat-free mass (FFM) were associated with decreasing AHI
These associations were particularly evident in younger adults
Analyses were stratified by sex, age, and BMI
The sample included 5,381 adults undergoing polysomnography and bioimpedance analysis
Results
Intracellular and total body water content were associated with increasing AHI.
Both intracellular and total body water were positively associated with AHI
Hydration parameters were included alongside fat and muscle composition measures in multivariable models
Associations including hydration parameters tended to attenuate with age
A unit increase in BMI and water content were linked to increasing N1 sleep stage
Results
Adiposity was associated with increased wake after sleep onset (WASO), while bone mass was associated with reduced WASO.
A unit increase in adiposity was associated with increasing WASO
Bone mass (BONEM) was associated with reduced WASO
These associations were assessed using multivariable linear regression adjusted for age, sex, and BMI
Findings were part of broader analyses linking body composition to sleep architecture parameters
Results
Psoas muscle mass and bone mass were associated with deeper sleep stages, while BMI and water content were associated with increased N1 (lighter) sleep.
A unit increase in BMI and water content were linked to increasing N1 stage sleep
Increases in psoas muscle mass (PMM) and bone mass (BONEM) were associated with increasing deeper sleep stages
These associations reflect the relationship between body composition and sleep architecture beyond just AHI
Analyses were conducted across sex, age, and BMI strata
Results
Associations between body composition parameters and AHI were stronger in females and in individuals with obesity compared to other subgroups.
Stratified analyses were performed by sex, age, and BMI categories
Stronger associations were found in females and individuals with obesity
Age- and sex-specific analyses showed that adiposity-AHI associations were stronger in younger adults
Hydration and adiposity parameters tended to attenuate with age in stratified models
Chuang Y, Liu W, Tsai C, Lin Y, Ho K, Chuang K, et al.. (2025). Associations between body composition, hydration status, and sleep architecture in obstructive sleep apnea.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2025.1666026