Association of obstructive sleep apnea severity with the composition of the upper airway microbiome

Seung-No Hong; Kang Jin Kim; Min-Gyung Baek; Hana Yi; Seung Hoon Lee; Dong-Young Kim; Chul Hee Lee; Chol Shin; Chae-Seo Rhee

doi:10.5664/jcsm.9640

Association of obstructive sleep apnea severity with the composition of the upper airway microbiome

J Clin Sleep Med. 2022 Feb 1;18(2):505-515. doi: 10.5664/jcsm.9640.

Authors

Seung-No Hong¹, Kang Jin Kim², Min-Gyung Baek³, Hana Yi⁴, Seung Hoon Lee⁵, Dong-Young Kim⁶, Chul Hee Lee⁶, Chol Shin⁷, Chae-Seo Rhee^{6

8}

Affiliations

¹ Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea.
² Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea.
³ Department of Public Health Sciences, Korea University, Seoul, Korea.
⁴ School of Biosystems and Biomedical Sciences, Korea University, Seoul, Korea.
⁵ Department of Otorhinolaryngology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Korea.
⁶ Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
⁷ Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Korea.
⁸ Sensory Organ Research Institute, Medical Research Center, Seoul National University, Seoul, Korea.

Abstract

Study objectives: Although the airway mucosal system plays a pivotal role in the pathogenesis of obstructive sleep apnea (OSA), the underlying disease mechanism remains unclear. The microbiome greatly impacts human health and disease, particularly in the mucosa, where it can have direct interactions. In this study, we aimed to analyze the microbiome composition in the upper airway mucosa of individuals with and without OSA to identify potential disease severity-related microbial signatures.

Methods: This population-based cohort study involved 92 participants (mean age = 62.7 ± 5.8 years; male-to-female ratio = 0.74) who underwent a physical examination and sleep study. Upper airway swab samples were collected from the nasopharyngeal mucosa to evaluate the microbiome based on 16S rRNA gene pyrosequencing. The relationship between microbiome composition and sleep parameters was explored through bioinformatics analysis.

Results: The average apnea-hypopnea index was 7.75 ± 6.5 events/h. Proteobacteria, Firmicutes, and Actinobacteria were the predominant phyla in the nasopharyngeal microbiota in all participants. Simpson diversity indexes were higher in patients with OSA (0.6435 ± 0.2827) than in the control patients (0.6095 ± 0.2683); however, the difference was not significant (P = .1155). Specific anaerobes negatively correlated with the lowest oxygen saturation level during sleep (sum of powered score (1) = -117.47; P = .0052).

Conclusions: The upper airway microbiome of older patients with mild-moderate OSA exhibited minor differences in composition compared with that of individuals without OSA, possibly owing to environmental changes in the upper airway mucosa resulting from recurrent airway obstruction and intermittent hypoxia in patients with OSA.

Citation: Hong S-N, Kim KJ, Baek M-G, et al. Association of obstructive sleep apnea severity with the composition of the upper airway microbiome. J Clin Sleep Med. 2022;18(2):505-515.

Keywords: microbiome; mucosa; obstructive sleep apnea; pathogenesis; upper airway.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cohort Studies
Female
Humans
Male
Microbiota* / genetics
Middle Aged
Polysomnography
RNA, Ribosomal, 16S / genetics
Sleep Apnea, Obstructive* / microbiology

Substances

RNA, Ribosomal, 16S