pp 1-9 | Cite as

Nutritional Status and Dietary Patterns in Adults with Severe Obstructive Sleep Apnea

  • Anna Jeznach–Steinhagen
  • Katarzyna OkręglickaEmail author
  • Aneta Nitsch–Osuch
  • Aneta Czerwonogrodzka-Senczyna
  • Małgorzata Barnaś
Part of the Advances in Experimental Medicine and Biology book series


Obstructive sleep apnea (OSA) is associated with daytime sleepiness, obesity, and lifestyle and dietary changes. The potential role of diet in OSA has been largely unexplored. The aim of the study was to assess nutritional status and dietary patterns in OSA patients. The study was conducted in 137 adult patients (48 women and 89 men) aged 31–79 suffering from OSA. The following diagnostic procedures were undertaken: polysomnography, anthropometric measurements, and a dietary pattern questionnaire. We found that 128 (93.4%) patients were overweight or obese with the mean body mass index (BMI) of 33.2 ± 6.1 kg/m2 and weight of 98.0 ± 20.2 kg. The mean percentage of total body fat was 45.0 ± 5.5% in women and 32.5 ± 5.5% in men. Obesity was associated with the severity of OSA, expressed by apnea/hypopnea index. We further found that the waist-to-hip ratio in women, but the neck circumference or percentage of body fat in men, characterizes best the OSA patients. Referring to dietary habits, half of the patients consumed white bread on a daily basis, 35.8% of them had whole grain bread in the diet, and only 16.8% consumed fish at least two portions a week. A third of patients used butter as a spread for bread or a source of fat for cooking, 2.9% of them used soft margarine, and 20.4% used olive or canola oil. Fruits and vegetables were consumed by 60% and 38% of patients, respectively. Refined sugar and sweets were used by 31.4% of patients every day. We conclude that excessive body weight, which may portend the development of OSA, is characterized by different anthropometric variables in men and women. Further, improper dietary habits seem conducive to the gain in body weight and thus may be at play in the pathogenesis of OSA.


Body fat Dietary patterns Nutritional status Obesity Obstructive sleep apnea 


Conflict of Interest

The authors declare no conflicts of interest in relation to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of the Medical University of Warsaw in Poland.

Informed Consent

Written informed consent was obtained from all individual participants included in the study.


  1. Araghi MH, Chen YF, Jagielski A, Choudhury S, Banerjee D, Hussain S, Thomas GN, Taheri S (2013) Effectiveness of lifestyle interventions on obstructive sleep apnea (OSA): systematic review and meta-analysis. Sleep 36(10):1553–1562Google Scholar
  2. Carneiro-Barrera A, Diaz-Roman A, Guillen-Riquelme A, Buela-Casal G (2019) Weight loss and lifestyle interventions for obstructive sleep apnoea in adults: systematic review and meta-analysis. Obes Rev 20(5):750–762Google Scholar
  3. Cho JH, Choi JH, Suh JD, Ryu S, Cho SH (2016) Comparison of anthropometric data between Asian and Caucasian patients with obstructive sleep apnea: a meta-analysis. Clin Exp Otorhinolaryngol 9(1):1–7Google Scholar
  4. Cizza G, de Jonge L, Piaggi P, Mattingly M, Zhao X, Lucassen E, Rother KI, Sumner AE, Csako G, NIDDK Sleep Extension Study (2014) Neck circumference is a predictor of metabolic syndrome and obstructive sleep apnea in short-sleeping obese men and women. Metab Syndr Relat Disord 12(4):231–241Google Scholar
  5. Davidson TM, Patel MR (2008) Waist circumference and sleep disordered breathing. Laryngoscope 118(2):339–347Google Scholar
  6. de Melo CM, Del Re MP, Dos Santos Quaresma MVL, Moreira Antunes HK, Togeiro SM, Lima Ribeiro SM, Tufik S, de Mello MT (2019) Relationship of evening meal with sleep quality in obese individuals with obstructive sleep apnea. Clin Nutr ESPEN 29:231–236Google Scholar
  7. Earl DE, Lakhani SS, Loriaux DB, Spector AR (2019) Predictors of moderate to severe obstructive sleep apnea: identification of sex differences. Sleep Breath 23(4):1151–1158Google Scholar
  8. Hori T, Sugita Y, Koga E, Shirakawa S, Inoue K, Uchida S, Kuwahara H, Kousaka M, Kobayashi T, Tsuji Y, Terashima M, Fukuda K, Fukuda N, Sleep Computing Committee of the Japanese Society of Sleep Research Society (2001) Proposed supplements and amendments to ‘A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects’, the Rechtschaffen & Kales (1968) standard. Psychiatry Clin Neurosci 55(3):305–310Google Scholar
  9. Ip MS, Lam B, Lauder IJ, Tsang KW, Chung KF, Mok YW, Lam WK (2001) A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong. Chest 119(1):62–69Google Scholar
  10. Ip MS, Lam B, Tang LC, Lauder IJ, Ip TY, Lam WK (2004) A community study of sleep-disordered breathing in middle-aged Chinese women in Hong Kong: prevalence and gender differences. Chest 125(1):127–134Google Scholar
  11. Kang HH, Kang JY, Ha JH, Lee J, Kim SK, Moon HS, Lee SH (2014) The associations between anthropometric indices and obstructive sleep apnea in a Korean population. PLoS One 9(12):e114463Google Scholar
  12. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG (2017) Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of sleep medicine clinical practice guideline. J Clin Sleep Med 13(3):479–504Google Scholar
  13. Kim J, In K, Kim J, You S, Kang K, Shim J, Lee S, Lee J, Lee S, Park C, Shin C (2004) Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med 170(10):1108–1113Google Scholar
  14. Kumor M, Bielicki P, Barnas M, Przybylowski T, Zielinski J, Chazan R (2013) Prevalence of metabolic syndrome diagnosis in patients with obstructive sleep apnoea syndrome according to adopted definition. Pneumonol Alergol Pol 81(5):417–423Google Scholar
  15. Lim YH, Choi J, Kim KR, Shin J, Hwang KG, Ryu S, Cho SH (2014) Sex-specific characteristics of anthropometry in patients with obstructive sleep apnea: neck circumference and waist-hip ratio. Ann Otol Rhinol Laryngol 123(7):517–523Google Scholar
  16. Onat A, Hergenc G, Yuksel H, Can G, Ayhan E, Kaya Z, Dursunoğlu D (2009) Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutr 28(1):46–51Google Scholar
  17. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM (2013) Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 177(9):1006–1014Google Scholar
  18. Plywaczewski R, Bednarek M, Jonczak L, Zielinski J (2008) Sleep-disordered breathing in a middle-aged and older Polish urban population. J Sleep Res 17(1):73–81Google Scholar
  19. Polesel DN, Nozoe KT, Tufik SB, Bezerra AG, Fernandes MTB, Bittencourt L, Tufik S, Andersen ML, Hachul H (2019) Gender differences in the application of anthropometric measures for evaluation of obstructive sleep apnea. Sleep Sci 12(1):2–9Google Scholar
  20. Reid M, Maras JE, Shea S, Wood AC, Castro-Diehl C, Johnson DA, Huang T, Jacobs DR Jr, Crawford A, St-Onge MP, Redline S (2019) Association between diet quality and sleep apnea in the Multi-Ethnic Study of Atherosclerosis. Sleep 42(1).
  21. Simpson L, Mukherjee S, Cooper MN, Ward KL, Lee JD, Fedson AC, Potter J, Hillman DR, Eastwood P, Palmer LJ, Kirkness J (2010) Sex differences in the association of regional fat distribution with the severity of obstructive sleep apnea. Sleep 33(4):467–474Google Scholar
  22. Sutherland K, Keenan BT, Bittencourt L, Chen NH, Gislason T, Leinwand S, Magalang UJ, Maislin G, Mazzotti DR, McArdle N, Mindel J, Pack AI, Penzel T, Singh B, Tufik S, Schwab RJ, Cistulli PA, SAGIC Investigators (2019) A global comparison of anatomic risk factors and their relationship to obstructive sleep apnea severity in clinical samples. J Clin Sleep Med 15(4):629–639Google Scholar
  23. Tom C, Roy B, Vig R, Kang DW, Aysola RS, Woo MA, Harper RM, Kumar R (2018) Correlations between waist and neck circumferences and obstructive sleep apnea characteristics. Sleep Vigil 2(2):111–118Google Scholar
  24. Udwadia ZF, Doshi AV, Lonkar SG, Singh CI (2004) Prevalence of sleep-disordered breathing and sleep apnea in middle-aged urban Indian men. Am J Respir Crit Care Med 169(2):168–173Google Scholar
  25. Young T, Shahar E, Nieto FJ, Redline S, Newman AB, Gottlieb DJ, Walsleben JA, Finn L, Enright P, Samet JM, Sleep Heart Health Study Research Group (2002) Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med 162(8):893–900Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Anna Jeznach–Steinhagen
    • 1
  • Katarzyna Okręglicka
    • 2
    Email author
  • Aneta Nitsch–Osuch
    • 2
  • Aneta Czerwonogrodzka-Senczyna
    • 1
  • Małgorzata Barnaś
    • 3
  1. 1.Department of Clinical DieteticsMedical University of WarsawWarsawPoland
  2. 2.Department of Social Medicine and Public HealthMedical University of WarsawWarsawPoland
  3. 3.Department of Internal Medicine, Pulmonary Diseases and AllergyMedical University of WarsawWarsawPoland

Personalised recommendations