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We included 680 participants who underwent standardised overnight polysomnography between 2008 and 2012 as part of the Study of Health in Pomerania in a sleep laboratory in Greifswald, Germany. The apnea\u2010hypopnea index was used as a marker of obstructive sleep apnea severity and the parapharyngeal fat pad volume, as our variable of interest, was analysed based on Magnetic Resonance Imaging data by automated image segmentation. We performed an ordinal logistic regression analysis to test the effect of parapharyngeal fat pad volume on apnea\u2010hypopnea index, controlling for body\u2010mass index as a confounder. The results indicated that greater parapharyngeal fat volume was associated with a higher apnea\u2013hypopnea index in an unadjusted analysis. After adjustment for body\u2010mass index, this association was no longer significant. An exploratory body\u2010mass index\u2010stratified analysis suggested that the association between parapharyngeal fat volume and apnea\u2013hypopnea index may be present primarily in non\u2010obese individuals. These findings highlight the importance of considering body\u2010mass index as a measure for overall obesity when evaluating the specific role of parapharyngeal fat in obstructive sleep apnea.<\/jats:p>","DOI":"10.1111\/jsr.70365","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:16:53Z","timestamp":1779682613000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Parapharyngeal Fat Pads as an Obesity\u2010Related Parameter for Apnea\u2010Hypopnea Index Severity"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5423-082X","authenticated-orcid":false,"given":"Antonia","family":"Felix","sequence":"first","affiliation":[{"name":"Department of Prosthodontics, Centre for Dental, Oral and Maxillofacial Medicine University of Greifswald  Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amro","family":"Daboul","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Centre for Dental, Oral and Maxillofacial Medicine University of Greifswald  Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatyana","family":"Ivanovska","sequence":"additional","affiliation":[{"name":"Faculty of Electrical Engineering, Media and Computer Science East Bavarian Technical University of Amberg\u2010Weiden  Weiden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0243-2435","authenticated-orcid":false,"given":"Peter","family":"Meisel","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Centre for Dental, Oral and Maxillofacial Medicine University of Greifswald  Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Ewert","sequence":"additional","affiliation":[{"name":"Department for Internal Medicine B University of Greifswald  Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Fietze","sequence":"additional","affiliation":[{"name":"Interdisciplinary Sleep Medicine Centre Charit\u00e9 University Hospital  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Penzel","sequence":"additional","affiliation":[{"name":"Interdisciplinary Sleep Medicine Centre Charit\u00e9 University Hospital  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Centre for Dental, Oral and Maxillofacial Medicine University of Greifswald  Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325\u2010021\u201002412\u20101"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201008\u20101249OC"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00007008"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753\u20100407.13494"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/164_2021_558"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7916"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00177213"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010019\u201053515\u20105"},{"key":"e_1_2_12_10_1","unstructured":"Christensen R. 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