• Seung-No Hong, Kang Jin Kim, Min-Gyung Baek, Hana Yi, Seung Hoon Lee, Dong-Young Kim, Chul Hee Lee, Chol Shin, and Chae-Seo Rhee.
• Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea.
• J Clin Sleep Med. 2021 Aug 31.

Study ObjectivesAlthough 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.MethodsThis 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.ResultsThe average apnea-hypopnea index was 7.75 ± 6.5. 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 non-OSA controls (0.6095 ± 0.2683); however, the difference was not significant (P = .1155). Specific anaerobes negatively correlated with the lowest oxygen saturation level during sleep (SPU(1) = -117.47; P = .0052).ConclusionsThe 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.© 2021 American Academy of Sleep Medicine.

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