What is considered the biggest risk factor for obstructive sleep apnea (OSA)?

Obesity is widely recognized as the most significant risk factor for obstructive sleep apnea (OSA) due to its direct impact on the anatomy and function of the airway. Excess body weight, particularly around the neck and abdomen, can lead to increased pressure on the upper airway, causing it to become obstructed during sleep. This condition results in repeated episodes of apnea, or cessation of breathing, which can lead to a variety of health issues, including cardiovascular problems and increased mortality risk.

While factors such as age, smoking, and genetics can contribute to the development of OSA, obesity is more directly related to the pathophysiology of the condition. Age can increase the likelihood of muscle tone loss in the upper airway, smoking may increase inflammation and fluid retention, and genetics may predispose individuals to anatomical features conducive to OSA; however, these factors do not have as strong a correlation with the overall prevalence and severity of OSA as obesity does. Thus, obesity stands out as the primary risk factor for this condition.