Relationship of Neck Circumference and Obstructive Sleep Apnea: A Cross-sectional Study in Pakistani Population

Objective: This study aimed to determine the reliability of neck circumference in comparison to BMI for a measure of Obstructive Sleep Apnea and determine the interaction between neck circumference and the severity of apnea in the Pakistani adult population.

Materials and Methods: A total of 306 subjects, were recruited retrospectively for the cross-sectional research in the Department of Pulmonary Vascular and Sleep Disorders in Dow University Hospital, Karachi. We reviewed the hospital records to evaluate the BMI, neck circumference, and AHI from June 2018 to February 2022 by non-Random Purposive sampling. The patients 1) who were adults with age more than 18 years and 2) patients with obstructive sleep apnea who were diagnosed through the Polysomnography test were included. IBM SPSS statistics 25 was used for data analysis. Statistical significance was considered as a p-value <0.05.

Results: The average age was 52.3 ± 11.4 years. Results showed that sleep apnea was found to be more prevalent and severe in males than in females. Increased neck circumference is associated with the severity of sleep apnea and is found to be significant in male subjects (p=0.018) but not in females (0.577). The neck circumference and the BMI had a statistically significant relationship among the male group and female group (p=0.006 and p=<0.001) which shows that individually neck circumference is not a significant risk factor to diagnose OSA. In multivariate regression, we found a strong association between obesity (OR: 4.3; 95% CI: 2.03-9.38; p-value: 0.00) and males (OR: 2.3; 95% CI: 1.41-3.73; p-value: 0.001) among obstructive sleep apnea patients.

Conclusion: In conclusion, the individuals who have large neck circumference have raised BMI, and the traditional indicators for instance males, older age, and BMI were associated with OSA but a larger neck circumference as an independent element was not linked to OSA. In addition, the correlation of large necks with OSA is found to be significant in male subjects but not in females.