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

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)505-515
Number of pages11
JournalJournal of Clinical Sleep Medicine
Issue number2
Publication statusPublished - 2022 Feb 1

Bibliographical note

Funding Information:
All authors read and approved the final manuscript. Work for this study was supported by the Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Education of the Korean government (NRF-2017R1D1A1B03028964). The authors report no conflicts of interest.

Publisher Copyright:
© 2022 American Academy of Sleep Medicine. All rights reserved.


  • microbiome
  • mucosa
  • obstructive sleep apnea
  • pathogenesis
  • upper airway

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Pulmonary and Respiratory Medicine


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