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Cited by 99Obstructive Sleep Apnea ResearchSleep and related disordersNeuroscience of respiration and sleep

Progression of snoring and obstructive sleep apnoea: the role of increasing weight and time

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Berger, G., Berger, R., Oksenberg, A.·2009·European Respiratory Journal
DOI 10.1183/09031936.00075408
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Abstract

The aim of the present study was to examine the natural evolution of primary snoring and obstructive sleep apnoea (OSA) in adult male patients. Retrospective analysis was performed on 160 untreated patients with primary snoring and mild, moderate and severe OSA who had two polysomnographic recordings. The mean time between recordings (TBR) was 5.1±3 yrs. The mean apnoea/hypopnoea index (AHI), body mass index (BMI), and lowest arterial oxygen saturation level during rapid eye movement (REM) and non-REM sleep showed a significant worsening effect. The change in AHI differed among the groups showing a similar significant increase in AHI for primary snoring, mild and moderate OSA and an insignificant decrease for severe OSA patients. Stepwise linear regression showed that only ΔBMI and time were significant predictors for AHI change. A model for the mean AHI change showed that ΔAHI = (4.33×ΔBMI) + (0.66×TBR). After adjusting for confounders, multiple regression analysis indicated that age and high BMI, but not AHI, were significant risk factors for developing hypertension and/or cardiovascular disease. Patients with primary snoring and mild and moderate obstructive sleep apnoea had a similar increase in the apnoea/hypopnoea index over time, which depended mainly on weight gain and, to a lesser extent, on time.

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  • Several investigators showed an increase of severity in mild to moderate sleep apnoea patients over time independently of body mass index.

    “While several investigators showed an increase of severity in mild to moderate sleep apnoea patients over time independently of the BMI, others failed to demonstrate deterioration of upper airway resistance syndromes or found improvements of respiratory disturbances 5, 18–24.”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [5]

    The Results report that AHI increased over time in patients with mild and moderate OSA, and that time predicted AHI change after adjustment for BMI change (page not available). But the Abstract and Discussion say progression depended mainly on weight gain; the independent effect of time was estimated across all severity groups, not established specifically for mild-to-moderate patients. (LLM, conf=0.84)

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  • Other investigators failed to demonstrate deterioration of upper airway resistance syndromes or found improvements of respiratory disturbances.

    “While several investigators showed an increase of severity in mild to moderate sleep apnoea patients over time independently of the BMI, others failed to demonstrate deterioration of upper airway resistance syndromes or found improvements of respiratory disturbances 5, 18–24.”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [5]

    The opening section reports that some longitudinal studies found apnoea status stable over time or improved, supporting the claim about respiratory disturbances. It discusses snoring and obstructive sleep apnoea, however, and does not establish the more specific claim about upper airway resistance syndromes. (LLM, conf=0.84)

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Cites

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Research works printed but not linked: 5

  1. [1]1. Lugaresi E, Cirignotta F, Gerardi R, et al. Snoring and sleep apnoea: natural history of heavy snorers disease. In: Guilleminault C, Partinen M, eds. Obstructive Sleep Apnoea Syndrome. Clinical Research and Treatment. New York, Raven Press, 1989; pp. 25-36.
  2. [8]8. Young T, Peppard PE, Gotlieb DJ. Epidemiology of obstructive sleep apnoea. Am J Respir Crit Care Med 2002; 165: 1217-1239.
  3. [12]12. Mason WJ, Ancoli Israel S, Kripke DF. Apnoea revised: a longitudinal follow up. Sleep 1989; 12: 423-429.
  4. [13]13. Rosenthal LD, Roehrs TA, Roth T. Natural course of sleep apnoea: a two year follow up. In: Kuna ST, Surrat PM, Remmers JE eds. Sleep and Respiration in Aging Adults. New York, Elsevier, 1991; p. 348.
  5. [21]21. Oksenberg A, Silverberg DS, Arons E, Radwan H. Posi- tional vs nonpositional obstructive sleep apnoea patients. Anthropomorphic, nocturnal polysomnographic and mul- tiple sleep latency test data. Chest 1997; 112: 629-639.

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Authors
Berger, G., Berger, R., & Oksenberg, A.
Affiliations
  • Loewenstein Hospital Rehabilitation Center (IL)
  • Meir Medical Center (IL)
ORCID
Oksenberg, A.
Venue
European Respiratory Journal
Publisher
European Respiratory Society (ERS)
Published
2008-11-14
Volume
33
Issue
2
Pages
338-345
ISSN
  • 0903-1936 (ISSN-L)
  • 1399-3003
DOI
10.1183/09031936.00075408
OpenAlex
W2023673080
Cited by
99
References
25
Citations by year
2026: 1 · 2025: 1 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 11 · 2020: 6 · 2019: 3 · 2018: 2 · 2017: 3 · 2016: 8 · 2015: 6 · 2014: 14 · 2013: 9 · 2012: 9
FWCI
3.38
Type
journal article
Language
en
Open access
Locations
  • European Respiratory Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
Keywords
obstructive sleep apnea, primary snoring, disease progression, body mass index, weight gain, apnea-hypopnea index, untreated patients, arterial oxygen saturation, hypertension, cardiovascular risk factors, adult male
MeSH terms
Adult, Aged, Body Weight, Female, Humans, Male, Middle Aged, Oxygen, Retrospective Studies, Snoring, Body Mass Index, Linear Models, Polysomnography, Disease Progression, Sleep Apnea, Obstructive

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