open access

Vol 76, No 2 (2017)
Original article
Submitted: 2016-07-01
Accepted: 2016-08-14
Published online: 2016-09-28
Get Citation

What can anthropometric measurements tell us about obstructive sleep apnoea?

A. Yilmaz1, M. Akcaalan2
·
Pubmed: 27714729
·
Folia Morphol 2017;76(2):301-306.
Affiliations
  1. Department of Anatomy, Faculty of Medicine, Trakya University, Edirne, Turkey, Türkiye
  2. Sakarya University Department of Anatomy, Faculty of Medicine, Sakarya University, Turkey, Türkiye

open access

Vol 76, No 2 (2017)
ORIGINAL ARTICLES
Submitted: 2016-07-01
Accepted: 2016-08-14
Published online: 2016-09-28

Abstract

Background: Clinical detection of anatomic narrowing of the upper airway may facilitate early recognition of obstructive sleep apnoea (OSA). The aim of this study was to investigate whether anthropometric measurement can be used to predict OSA.

Materials and methods: One hundred forty-seven subject were included from those patients who were referred to our sleep laboratory with suspected sleep apnoea. All patients were divided two groups with respect to the apnoea-hypopnoea index (AHI). The first group was diagnosed as OSA, AHI greater than 5. The second group was not diagnosed with OSA, AHI less than 5 (non-OSA control). Anthropometric measurements such as lower face height (LFH), interincisial distance, nose height, anterior neck height (ANH), lateral neck height, posterior neck height (PNH), ramus mandible height, corpus mandible height (CML), bigonial distance (BGD), neck width, and neck depth were assessed.

Results: Patients with OSA had higher body mass index (BMI) and larger LFH, ANH, thyromental distance, CML, BGD, and neck circumference than those without OSA (p < 0.0001, p < 0.0001, p < 0.0001, p < 0.0001, p < 0.0001, p = 0.023, p < 0.0001, respectively). There was no difference between the two groups in terms of other parameters.

Conclusions: In this study, it was determined that BMI, lower face height, neck height, mandible length, bigonial width, thyromental distance and neck circumference are in significant relationship with sleep disordered breathing. Thus, these measurements may be used in clinical practice for prediction of OSA.

Abstract

Background: Clinical detection of anatomic narrowing of the upper airway may facilitate early recognition of obstructive sleep apnoea (OSA). The aim of this study was to investigate whether anthropometric measurement can be used to predict OSA.

Materials and methods: One hundred forty-seven subject were included from those patients who were referred to our sleep laboratory with suspected sleep apnoea. All patients were divided two groups with respect to the apnoea-hypopnoea index (AHI). The first group was diagnosed as OSA, AHI greater than 5. The second group was not diagnosed with OSA, AHI less than 5 (non-OSA control). Anthropometric measurements such as lower face height (LFH), interincisial distance, nose height, anterior neck height (ANH), lateral neck height, posterior neck height (PNH), ramus mandible height, corpus mandible height (CML), bigonial distance (BGD), neck width, and neck depth were assessed.

Results: Patients with OSA had higher body mass index (BMI) and larger LFH, ANH, thyromental distance, CML, BGD, and neck circumference than those without OSA (p < 0.0001, p < 0.0001, p < 0.0001, p < 0.0001, p < 0.0001, p = 0.023, p < 0.0001, respectively). There was no difference between the two groups in terms of other parameters.

Conclusions: In this study, it was determined that BMI, lower face height, neck height, mandible length, bigonial width, thyromental distance and neck circumference are in significant relationship with sleep disordered breathing. Thus, these measurements may be used in clinical practice for prediction of OSA.

Get Citation

Keywords

obstructive sleep apnoea, anthropometry, neck, head, airway

About this article
Title

What can anthropometric measurements tell us about obstructive sleep apnoea?

Journal

Folia Morphologica

Issue

Vol 76, No 2 (2017)

Article type

Original article

Pages

301-306

Published online

2016-09-28

Page views

1713

Article views/downloads

1324

DOI

10.5603/FM.a2016.0058

Pubmed

27714729

Bibliographic record

Folia Morphol 2017;76(2):301-306.

Keywords

obstructive sleep apnoea
anthropometry
neck
head
airway

Authors

A. Yilmaz
M. Akcaalan

References (40)
  1. Abramson Z, Susarla S, August M, et al. Three-dimensional computed tomographic analysis of airway anatomy in patients with obstructive sleep apnea. J Oral Maxillofac Surg. 2010; 68(2): 354–362.
  2. Banabilh SM, Samsudin AR, Suzina AH, et al. Facial profile shape, malocclusion and palatal morphology in Malay obstructive sleep apnea patients. Angle Orthod. 2010; 80(1): 37–42.
  3. Bingol Z, Pıhtılı A, Cagatay P, et al. Clinical predictors of obesity hypoventilation syndrome in obese subjects with obstructive sleep apnea. Respir Care. 2015; 60(5): 666–672.
  4. Bouloukaki I, Kapsimalis F, Mermigkis C, et al. Prediction of obstructive sleep apnea syndrome in a large Greek population. Sleep Breath. 2011; 15(4): 657–664.
  5. Cho JH, Choi JiHo, Suh JD, et al. Comparison of anthropometric data between asian and caucasian patients with obstructive sleep apnea: a meta-analysis. Clin Exp Otorhinolaryngol. 2016; 9(1): 1–7.
  6. Chung S, Yoon IY, Shin YK, et al. Endothelial dysfunction and C-reactive protein in relation with the severity of obstructive sleep apnea syndrome. Sleep. 2007; 30(8): 997–1001.
  7. Dobrowolska-Zarzycka M, Dunin-Wilczyńska I, Szymańska J. Craniofacial structure in patients with obstructive sleep apnoea. Folia Morphol. 2016; 75(3): 311–315.
  8. Emara TA, Hassan MH, Mohamad AS, et al. Anterolateral Advancement Pharyngoplasty: A New Technique for Treatment of Obstructive Sleep Apnea. Otolaryngol Head Neck Surg. 2016; 155(4): 702–707.
  9. Enciso R, Nguyen M, Shigeta Y, et al. Comparison of cone-beam CT parameters and sleep questionnaires in sleep apnea patients and control subjects. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109(2): 285–293.
  10. Enciso R, Shigeta Y, Nguyen M, et al. Comparison of cone-beam computed tomography incidental findings between patients with moderate/severe obstructive sleep apnea and mild obstructive sleep apnea/healthy patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 114(3): 373–381.
  11. Friedman M, Tanyeri H, La Rosa M, et al. Clinical predictors of obstructive sleep apnea. Laryngoscope. 1999; 109(12): 1901–1907.
  12. Gulati A, Chate RAC, Howes TQ. Can a single cephalometric measurement predict obstructive sleep apnea severity? J Clin Sleep Med. 2010; 6(1): 64–68.
  13. Hiremath AS, Hillman DR, James AL, et al. Relationship between difficult tracheal intubation and obstructive sleep apnoea. Br J Anaesth. 1998; 80(5): 606–611.
  14. Hora F, Nápolis LM, Daltro C, et al. Clinical, anthropometric and upper airway anatomic characteristics of obese patients with obstructive sleep apnea syndrome. Respiration. 2007; 74(5): 517–524.
  15. Kawaguchi Y, Fukumoto S, Inaba M, et al. Different impacts of neck circumference and visceral obesity on the severity of obstructive sleep apnea syndrome. Obesity (Silver Spring). 2011; 19(2): 276–282.
  16. Kum RO, Ozcan M, Yılmaz YF, et al. The Relation of the Obstruction Site on Muller's Maneuver with BMI, Neck Circumference and PSG Findings in OSAS. Indian J Otolaryngol Head Neck Surg. 2014; 66(2): 167–172.
  17. Lim YH, Choi J, Kim KR, et al. Sex-specific characteristics of anthropometry in patients with obstructive sleep apnea: neck circumference and waist-hip ratio. Ann Otol Rhinol Laryngol. 2014; 123(7): 517–523.
  18. Liu KH, Chu WCW, To KW, et al. Sonographic measurement of lateral parapharyngeal wall thickness in patients with obstructive sleep apnea. Sleep. 2007; 30(11): 1503–1508.
  19. Marshall NS, Wong KKH, Liu PY, et al. Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep. 2008; 31(8): 1079–1085.
  20. Martinez-Rivera C, Abad J, Fiz JA, et al. Usefulness of truncal obesity indices as predictive factors for obstructive sleep apnea syndrome. Obesity (Silver Spring). 2008; 16(1): 113–118.
  21. Mayer P, Pépin JL, Bettega G, et al. Relationship between body mass index, age and upper airway measurements in snorers and sleep apnoea patients. Eur Respir J. 1996; 9(9): 1801–1809.
  22. Neligan PJ, Porter S, Max B, et al. Obstructive sleep apnea is not a risk factor for difficult intubation in morbidly obese patients. Anesth Analg. 2009; 109(4): 1182–1186.
  23. Onat A, Hergenç G, Yüksel H, et al. Neck circumference as a measure of central obesity: associations with metabolic syndrome and obstructive sleep apnea syndrome beyond waist circumference. Clin Nutr. 2009; 28(1): 46–51.
  24. Ozbek MM, Miyamoto K, Lowe AA, et al. Natural head posture, upper airway morphology and obstructive sleep apnoea severity in adults. Eur J Orthod. 1998; 20(2): 133–143.
  25. Pae EK, Lowe AA, Fleetham JA. A role of pharyngeal length in obstructive sleep apnea patients. Am J Orthod Dentofacial Orthop. 1997; 111(1): 12–17.
  26. Pamidi S, Knutson KL, Ghods F, et al. Depressive symptoms and obesity as predictors of sleepiness and quality of life in patients with REM-related obstructive sleep apnea: cross-sectional analysis of a large clinical population. Sleep Med. 2011; 12(9): 827–831.
  27. Pracharktam N, Nelson S, Hans MG, et al. Cephalometric assessment in obstructive sleep apnea. Am J Orthod Dentofacial Orthop. 1996; 109(4): 410–419.
  28. Raskin S, Gilon Y, Limme M. [Cephalometric assessment in obstructive sleep apnea and hypopnea syndrome]. Rev Stomatol Chir Maxillofac. 2002; 103(3): 158–163.
  29. Ryu HH, Kim CH, Cheon SM, et al. The usefulness of cephalometric measurement as a diagnostic tool for obstructive sleep apnea syndrome: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 119(1): 20–31.
  30. Schellenberg JB, Maislin G, Schwab RJ. Physical findings and the risk for obstructive sleep apnea. The importance of oropharyngeal structures. Am J Respir Crit Care Med. 2000; 162(2 Pt 1): 740–748.
  31. Seetho IW, Parker RJ, Craig S, et al. Obstructive sleep apnea is associated with increased arterial stiffness in severe obesity. J Sleep Res. 2014; 23(6): 700–708.
  32. Simpson L, Mukherjee S, Cooper MN, et al. Sex differences in the association of regional fat distribution with the severity of obstructive sleep apnea. Sleep. 2010; 33(4): 467–474.
  33. Soylu AC, Levent E, Sarıman N, et al. Obstructive sleep apnea syndrome and anthropometric obesity indexes. Sleep Breath. 2012; 16(4): 1151–1158.
  34. Sreedharan SE, Agrawal P, Rajith RS, et al. Clinical and polysomnographic predictors of severe obstructive sleep apnea in the South Indian population. Ann Indian Acad Neurol. 2016; 19(2): 216–220.
  35. Subramanian S, Jayaraman G, Majid H, et al. Influence of gender on continuous positive airway pressure requirements in patients with obstructive sleep apnea syndrome. Sleep Breath. 2011; 15(4): 781–784.
  36. Susarla SM, Thomas RJ, Abramson ZR, et al. Biomechanics of the upper airway: Changing concepts in the pathogenesis of obstructive sleep apnea. Int J Oral Maxillofac Surg. 2010; 39(12): 1149–1159.
  37. Takai Y, Yamashiro Y, Satoh D, et al. Cephalometric assessment of craniofacial morphology in Japanese male patients with obstructive sleep apnea-hypopnea syndrome. Sleep Biol Rhythms. 2012; 10(3): 162–168.
  38. Whittle AT, Marshall I, Mortimore IL, et al. Neck soft tissue and fat distribution: comparison between normal men and women by magnetic resonance imaging. Thorax. 1999; 54(4): 323–328.
  39. Young T, Finn L, Peppard PE, et al. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep. 2008; 31(8): 1071–1078.
  40. Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993; 328(17): 1230–1235.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.: +48 58 320 94 94, faks: +48 58 320 94 60, e-mail: viamedica@viamedica.pl