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Eric J. Kezirian, MD, MPH; Ceyda E. Kirisoglu, MD; Robert W. Riley, MD, DDS; Edward Chang, DDS, MD; Christian Guilleminault, MD, BiolD; Nelson B. Powell, MD, DDS

Arch Otolaryngol Head Neck Surg. 2008;134(12):1270-1275.

Objective  To examine the association between sleep disordered breathing severity and resting energy expenditure (REE).

Design  Cross-sectional.

Setting  University-based academic medical center.

Participants  Two hundred twelve adults with signs or symptoms of sleep disordered breathing underwent medical history, physical examination, level I attended polysomnography, and determination of REE using an indirect calorimeter.

Main Outcome Measure  Mean REE.

Results  Seventy-one percent (151 of 212) of the study population were male, and the mean (SD) age was 42.3 (12.6) years. The mean (SD) body mass index, calculated as weight in kilograms divided by height in meters squared, was 28.3 (7.3). The mean (SD) apnea-hypopnea index was 25.4 (27.2), and the lowest oxygen saturation during the sleep study was 86.9% (9.5%). The mean (SD) REE was 1763 (417) kcal/d. Analysis of variance and univariate regression analysis showed an association between REE and several measures of sleep disordered breathing severity that persisted after adjustment for age, sex, and self-reported health status in multiple regression analysis. Only REE and the apnea-hypopnea index demonstrated an independent association after additional adjustment for body mass index (or body weight and height separately). This association did not differ between individuals with normal vs elevated body mass index.

Conclusions  Sleep disordered breathing severity is associated with REE. Although this association is largely confounded by body weight, there is an independent association with the apnea-hypopnea index.

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, School of Medicine, University of California, San Francisco (Dr Kezirian), Departments of Otolaryngology–Head and Neck Surgery (Drs Riley and Powell) and Psychiatry and Behavioral Science and Stanford University Sleep Disorders and Research Center (Drs Riley, Guilleminault, and Powell), Stanford University School of Medicine, Stanford, and Department of Head and Neck Surgery, Kaiser Permanente, Santa Rosa (Dr Chang), California; and Pulmonary Medicine and Sleep Disorders, Acibadem Kozyatagi Hospital, Istanbul, Turkey (Dr Kirisoglu).

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