Gender-Specific Association of Body Fat Composition with Risk of Obstructive Sleep Apnea among People Living With HIV/AIDS: A Cross-Sectional Study

Background: Obesity and regional fat distribution are among the strongest risk factors for obstructive sleep apnea (OSA) in the general population. People living with HIV (PLHIV) may be at increased risk of OSA because of their distinct body fat composition. This study examined the association of body fat composition with the risk of OSA in PLHIV. Methods: We conducted a cross-sectional prospective study at a tertiary HIV care unit, recruiting 400 PLHIV [female: 317, 79.2%; median age of 44 years; median year of HIV duration of 5 years]. Participants were surveyed using standardized instruments to assess the risk of OSA, sleep duration and, sleepiness. Body fat composition was evaluated with anthropometric measurements and bioelectric impedance Results: Sixty-three of the participants (15.8%; 95% confidence interval [CI], 12.4%–19.8%) had risk of OSA, while 24 (6.0%) of them had risk of OSA and excessive day time sleepiness and 30 (7.5%) had risk of OSA with concomitant short sleep duration. BMI and markers of central obesity were significantly associated with risk of OSA in females but not in males. Waist circumference, Waist to hip ratio, Visceral fat level performed similarly in predicting the risk of OSA in females with Area Under the Curve (AUC) of 0.668, 95% CI (0.613, 0.719); 0.704, 95% CI (0.651, 0.754); 0.663, 95% CI (0.608, 0.715) respectively, with VFL having the best accuracy. Conclusions: The risk of OSA among PLHIV was associated with measures of visceral adiposity in females and not in males.