Upper airway obstruction patterns among non-obese individuals with snoring and obstructive sleep apnea.

Background: Snoring is an inspiratory noise due to partialobstruction of the upper airways. It is commonly linked to a sleep problem known as obstructive sleep apnea (OSA). The clinical criteria of OSA in non-obese patients are distinct and warrant more investigation, despite being well-studied in the obese population. Objective: The aim of this study is to provide a diagnostic profile of snoring and OSA in non-obese patients using various assessment tools in order to identify upper airway obstruction patterns and potential risk factors in these patients to improve their management and prevent related comorbidities. Methodology: An observational cross-sectional study of 30 non-obese (BMI < 29.9) snorers (18 males and 12 females) with a mean age of 38.13 ± 8.4 years. All patients underwent polysomnography and thorough clinical examination, including searching for possible risk factors/co-morbidity, Epworth Sleepiness Score (ESS), Mallampati score, awake upper airway endoscopy combined with Muller maneuver, and drug-induced sleep endoscopy (DISE). Results: OSA presented in 80% of our patients, the age range of 17–58 years, apnea–hypopnea index (AHI) mean 20.63 ± 17.8 event/h, and its severity was mild 7 (23.3%), moderate 6 (20%), and severe 11 (36.7%). Findings of oral and nasal examination showed no association with AHI. Also, sleep endoscopy findings regarding specific structures causing upper airway obstruction showed no significant association. A positive correlation was found between the extent of retropalatal airway collapse and AHI. A notable association was found between smoking and AHI as a risk factor for OSA in non-obese individuals. No significant relationship was found between ESS, concomitant diseases, and AHI. Conclusion: OSA is common in non-obese patients and probably may be attributed to retropalatal/oropharyngeal airway collapse and associated with smoking as a risk factor. Further studies are warranted to reveal other pathophysiological aspects in this group of patients. [ABSTRACT FROM AUTHOR]