Increased energy intake regardless of diet macronutrient composition is positively associated with OSA severity according to a recent study published in the Plos One.
Obstructive sleep apnea (OSA) is characterized by upper airway obstruction during sleep, resulting in recurrent oxidative stress and sleep fragmentation. The severity of OSA is determined by the Apnea-hypopnea index (AHI), where a value of 5 to 14.9 breathing disturbances per hour of sleep is considered a mild burden, 15 to 29.9 is considered as moderate, and an AHI of 30 or greater is considered severe. The prevalence of OSA is increasing at an epidemic rate. Approximately 25% of men and 13% of women suffer from OSA worldwide [3]. A recent population-based study in Cyprus estimated that the prevalence of moderate to high risk for OSA is 50% in males and 18% in females The aim of this study was to examine whether individual nutrients (macronutrients, antioxidant vitamins) rather than energy restriction may potentially affect OSA severity in a representative population of Cyprus.

A total sample of 303 adults (>18 years old) with Cypriot citizenship and permanently residing in Cyprus were randomly selected. Selected patients have completed the food frequency questionnaire, and a physical activity questionnaire and underwent a sleep study to assess OSA severity.
Results of the study are:
Overall, 303 patients were included in this study, 169 (55.8%) had mild OSA (apnea-hypopnea index—AHI <15) and the remaining 83 (27.4%) had moderate to severe OSA (AHI>15). The mean age of all patients was 55.7 years old. Patients with moderate to severe OSA had significant higher BMI levels, higher consumption of calories, higher hip circumference, waist circumference, waist-hip ratio and neck circumference and higher consumption of folic acid compared with the patients with mild OSA (p<0.05).
Thus, the findings suggest that increased energy intake regardless of diet macronutrient composition is positively associated with OSA severity whereas higher folic acid intake seems to have a protective role.
Reference:
The relation of dietary components with the severity of obstructive sleep apnea in Cypriot patients: A randomized, stratified epidemiological study by Stavri Chrysostomou et al. published in the Plos One.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265148