ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Obesity
This article is part of the Research TopicLatest Insights and Translational Advances in Obstructive Sleep Apnoea (OSA)View all 4 articles
Associations Between Body Composition, Hydration Status, and Sleep Architecture in Obstructive Sleep Apnea
Provisionally accepted
- 1Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan
- 2Shang Ho Hospital, Taipei Medical University, Taipei City, Taiwan
- 3Taipei Medical University College of Biomedical Engineering, Taipei City, Taiwan
- 4The Chinese University of Hong Kong The Jockey Club School of Public Health and Primary Care, Hong Kong, Hong Kong, SAR China
- 5department of public Health, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- 6School of Respiratory Therapy, Taipei Medical University, Taipei, Taiwan
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Abstract Introduction: Obstructive sleep apnea (OSA) is linked to increased cardiovascular and metabolic risks. Although body mass index is a recognized risk factor, the roles of fat mass, muscle mass, and hydration status in influencing OSA severity and sleep architecture remain unclear. This study examined the associations between body composition and apnea-hypopnea index, sleep efficiency, and sleep stages across sex, age, and BMI strata. Materials and Methods: In this cross-sectional study, data from 5,381 adults undergoing overnight polysomnography and bioimpedance analysis were analyzed. Multivariable linear regression, adjusted for age, sex, and BMI were used, with additional analyses stratified by sex, age, and BMI. Results: A unit increase in fat percentage (FATP) and fat mass (FATM) were associated with increasing AHI, whereas increase in bone mass, and FFM were associated with decreasing AHI, particularly in younger adults. Intracellular and total body water associated with increasing AHI. Stratified analyses revealed stronger associations in females and individuals with obesity. A unit increase in adiposity associated with increasing WASO, while bone mass (BONEM) reduced WASO. A unit increase in BMI and water content were linked to increasing N1 stage, whereas increase in PMM and BONEM associated with increasing deeper stages. Age-and sex-specific analyses showed stronger adiposity-AHI associations in younger adults, while these including hydration parameters, tend to attenuate with age.
Keywords: AHI, Body Composition, Hydration status, osa, Polysomnography, sleep architecture
Received: 16 Jul 2025; Accepted: 24 Oct 2025.
Copyright: © 2025 Chuang, Liu, Tsai, Lin, Ho, Chuang and Chuang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hsiao-Chi Chuang, chuanghc@tmu.edu.tw
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