Relationship of body position, upper airway morphology, and severity of obstructive sleep apnea/hypopnea syndrome among Chinese patients

Abstract Conclusions: This study has shown that the body mass index (BMI), neck circumference, and modified Mallanpati grade (MMP) are predictive of severity of obstructive sleep apnea/hypopnea syndrome (OSAHS). The neck circumference and MMP were revealed to be important morphological features in the responders whose apnea/hyoponea index (AHI) was substantially decreased by positioning during sleep. Objective: The aim of this study was to assess the predictive power of routine physical examination of the upper airway by an otorhinolaryngologist to identify OSAHS in Chinese patients, and to clarify the interaction of lateral and supine sleeping positions with upper airway morphology in patients with OSAHS. Methods: In all, 103 consecutive patients with OSAHS (48 men and 65 women) underwent polysomnography and upper airway morphological examination. Upper airway morphology and anthropometric variables were evaluated to determine different severity of OSAHS in the responders and nonresponders. Results: The neck circumference, BMI, and MMP showed statistical correlations with AHI and decreased AHI for changed sleeping position. Multiple logistic regression analysis showed that the neck circumference and MMP were significant predictors for the responders (p = 0.023, odds ratio = 1.180 and p = 0.006, odds ratio = 1.922, respectively).

[1]  F. Yasuma,et al.  Morphological examination of upper airway in obstructive sleep apnea. , 2009, Auris, nasus, larynx.

[2]  F. Yasuma,et al.  Upper airway morphology in patients with obstructive sleep apnea syndrome: effects of lateral positioning. , 2009, Auris, nasus, larynx.

[3]  A. Oksenberg,et al.  Positional Therapy for Obstructive Sleep Apnea Patients: A 6‐Month Follow‐Up Study , 2006, The Laryngoscope.

[4]  H. Thulesius,et al.  Pharyngometric correlations with obstructive sleep apnea syndrome , 2004, Acta oto-laryngologica.

[5]  S. Tufik,et al.  Association of Systematic Head and Neck Physical Examination With Severity of Obstructive Sleep Apnea—Hypopnea Syndrome , 2003, The Laryngoscope.

[6]  Colin Macarthur,et al.  A decision rule for diagnostic testing in obstructive sleep apnea. , 2003, American journal of respiratory and critical care medicine.

[7]  A. Oksenberg,et al.  Apnoea characteristics across the night in severe obstructive sleep apnoea: influence of body posture. , 2001, The European respiratory journal.

[8]  D. Caldarelli,et al.  Clinical Predictors of Obstructive Sleep Apnea , 1999, The Laryngoscope.

[9]  Woodson Bt Predicting which patients will benefit from surgery for obstructive sleep apnea: the ENT exam. , 1999 .

[10]  B. Woodson Predicting which patients will benefit from surgery for obstructive sleep apnea: the ENT exam. , 1999, Ear, nose, & throat journal.

[11]  M. Crossley,et al.  Positional treatment vs continuous positive airway pressure in patients with positional obstructive sleep apnea syndrome. , 1999, Chest.

[12]  B. Woodson,et al.  Comparison of Methods of Airway Evaluation in Obstructive Sleep Apnea , 1997, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[13]  A. Oksenberg,et al.  Positional vs Nonpositional Obstructive Sleep Apnea Patients* Anthropomorphic, Nocturnal Polysomnographic, and Multiple Sleep Latency Test Data , 1997 .

[14]  R. Rosen,et al.  Obesity and weight loss in obstructive sleep apnea: a critical review. , 1996, Sleep.

[15]  P. Sheedy,et al.  Effects of body position on the upper airway of patients with obstructive sleep apnea. , 1995, American journal of respiratory and critical care medicine.

[16]  D. Pevernagie,et al.  Relations between sleep stage, posture and effective nasal CPAP levels in OSA. , 1992, Sleep.

[17]  D. Caldarelli,et al.  A comparative study of treatments for positional sleep apnea. , 1991, Sleep.

[18]  E A Hoffman,et al.  Evaluation of the upper airway in patients with obstructive sleep apnea. , 1991, Sleep.

[19]  J. Stradling,et al.  The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome. , 1990, The European respiratory journal.