RESEARCH PAPER
The influence of upper airways diameter on the intensity of obstructive sleep apnea
 
More details
Hide details
1
Chair and Department of Paedodontics, Medical University of Lublin, Poland
 
2
Chair and Department of Jaw Orthopedics, Medical University of Lublin, Poland
 
 
Ann Agric Environ Med. 2014;21(1):217-220
 
KEYWORDS
ABSTRACT
Introduction and Objective. Obstructive sleep apnea (OSA) is characterized by at least 5 ten-second-long episodes of apnea or hypopnea, per hour of sleep. This disease may lead to severe, life-threatening complications. Therefore, risk analysis and its influence on disease intensity is crucial for proper implementation of preventive treatments. Objective. To determine the relation between the intensity of OSA expressed in Apnea-Hypopnea Index (AHI), and the anterior-posterior diameter of upper airways at the levels of soft palate and tongue base. Material and Method. Medical records of 41 patients with sleep apnea (AHI>4) diagnosed through polysomnographic examination obstructive were used for the study. The data consisted of: age and gender, polysomnographic examination results (AHI), lateral cephalogram with cephalomertic analysis, together with measurements of the upper and lower pharyngeal depth according to McNamara. Statistical analysis was carried out in accordance with Pearson’s r correlation coefficient test (Statistica 8.0 software package). Results. Analysis of the influence of upper airways diameter on the intensity of OSA showed that the value of upper Airways diameter at the tongue base level had no statistically significant impact on the value of AHI (p=0.795). However, a statistically significant impact of the value of upper airways diameter on the AHI value (p=0.008) at the soft palate level was observed. Patients with OSA have narrowed upper airways diameter. The value of AHI increases with the decrease of upper diameter and is not dependent on a lower diameter value. Patients with a decreased upper airways diameter should be informed about potential breathing disorders during sleep.
 
REFERENCES (30)
1.
McNicolas WT. Diagnosis of obstructive sleep apnea in adults. Proc Am Thorac Soc. 2008; 5: 154–160.
 
2.
Doherty LS, Cullem JP, Nolan P, McNicholas WT. The human genioglossus response to negative airway pressure: stimulus timing and route of delivery. Exp Physiol. 2008; 93(2): 288–295.
 
3.
Levy P, Ryan S, Oldenburg O, Parati G. Sleep apnoea and the heart. Eur Respir Rev. 2013; 22: 333–352.
 
4.
Dumitrascu R, Tiede H, Eckermann J, Mayer K, Reichenberger F et al. Sleep apnea in precapillary pulmonary hypertension. Sleep Med. 2013; 14: 247–251.
 
5.
Barreiro B, Garcia L, Lozano L, Almagro P, Quintana S et al. Obstructive sleep apnea and matabolic syndrome in spanish population. Open Respir Med J. 2013; 18: 71–76.
 
6.
Tasali E, Ip MSP. Obstructive sleep apnea and metabolic syndrome: Alteration in glucose metabolism and inflammation. Proceedings of the ATS. 2008; 5: 207–217.
 
7.
Catarino R, Spratley J, Catarono I, Lunet N, Pais-Clemente M. Sleepiness and sleep-disordered breathing in truck drivers: Risk analysis of road accidents. Sleep Breath. 2014; 18(1): 59-68.
 
8.
Antonopoulous CN, Sergenta nis TN, Daskalopoulou SS, Petridou ET. Nasal continuous positive airway pressure (nCPAP) treatment for obstructive sleep apnea, road traffic accidents and driving simulator performance: a meta-analysis. Sleep Med Rev. 2011; 15: 301–310.
 
9.
Krieger J. Clinical presentations of sleep apnoea. Eur Respir Mon. 1998; 3: 75–105.
 
10.
Sung MW, Lee WH, Wee JH, Lee CH, Kim E et al. Factors associated with hypertrophy of the lingual tonsils in adults in sleep-disordered breathing. JAMA Otolaryngol Head Neck Surg. 2013; 139: 598–603.
 
11.
Cistulli PA, Richards GN, Palmisano RG, Unger G, Brethon-Jones M, Sullivan CE. Influence of maxillary constriction on nasal resistance and sleep apnea severity in patients with Marfan’s syndrome. Chest. 1996; 110: 1184–1188.
 
12.
Kushida CA, Efron B, Guilleminoult C. A predictive morphometric model for the obstructive sleep apnea syndrome. Ann Intern Med. 1997; 127: 581–587.
 
13.
Seto BH, Gotsopoulos H, Sims MR, Cistulli PA. Maxillary morphology in obstructive sleep apnoea syndrome. Eur J Orthod. 2001; 23: 703–714.
 
14.
McNamara J, Burdon W. Orthodontic and orthopedic treatment in mixed dentition. Needham Press, 1994.
 
15.
Segner D, Hasund A. Indywidualna kefalometria. Med Tour Press International Wydawnictwo Medyczne, 1996.
 
16.
Jung HJ, Kim JW, Lee CH, Chung YJ, Mo JH. A thyroglossal duct cyst causing obstructive sleep apnea in adult. Clin Exp Otorhinolaryngol. 2013; 6(3): 187–190.
 
17.
Friedel ME, Johnston DR, Singhal S, Khalili KA, Farrell CJ et al. Airway management and perioperative concerns in acromegaly patients undergoing endoscopic transsphenoidal syrgery for pituitary tumors. Otolaryngol Head Neck Surg. 2013; 149: 840–844.
 
18.
Mete T, Yalcin Y, Berker D, Ciftici B, Guven Firat S et al. Relationship between obstructive sleep apnea syndrome and thyroid diseases. Endocrine. 2013; 44: 723–728.
 
19.
Sedaghat AR, Anderson IC, McGinley BM, Rossberg MI, Redett RJ et al. Characterization of obstucive sleep apnea before and after tonguelip adhesion in children with micrognathia. Cleft Palate Craniofac J. 2012; 49: 21–26.
 
20.
Bacon WH, Turlot JC, Krieger J, Stierle JL. Cephalometric evaluation of pharyngeal obstructive factors in patients with sleep apnea syndrome. Angle Orthod. 1990; 60: 115–121.
 
21.
Özbek MM, Keisuke M, Lowe AA, Fleetham JA. Natural head posture, upper airway morphology and obstructive sleep apnoea severity in adults. Europ J Orthodontics. 1998; 20(2): 133–143.
 
22.
Pae EK, Lowe AA, Fleetham JA. A role of pharyngeal length in obstructive sleep apnea patients. Am J Orthod Dentofac Orthop. 1997; 111: 12–17.
 
23.
Pracharktam N, Nelson S, Hans MG, Broadbent BH, Redline S, Rosenberg C, et al. Cephalometric assessment in obstructive sleep apnea. Am J Orthod Dentofac Orthop. 1996; 109: 410–419.
 
24.
Tangugsorn V, Skatvedt O, Krogstadt O, Lyberg T. Obstructive sleep apnoea: a cephalometric study. Part I. Cervico-craniofacial skeletal morphology. Eur J Orthod. 1995; 17(1): 45–56.
 
25.
Johal A, Battagel J. An investigation into the changes in airway dimension and efficacy of mandibular advancement appliances in subjects with obstructive sleep apnoea. Brit J Orthod. 1999; 26: 205–210.
 
26.
Johal A, Sheriteh Z, Battagel J, Marshall C. The use of videofluoroscopy in assesement of the pharyngeal airway in obstructive sleep apnoea. Europ J Orthod. 2011; 33(2): 212–219.
 
27.
Martin SE, Mathur R, Marshall I, Douglas NJ. The effect of age, sex obesity and posture on upper airway size. Eur Respir J. 1997; 10: 2087–2090.
 
28.
Popovic RM, White DP. Gender differences in waking genioglossal EMG (GG-EMG) and pharyngeal resistance. Am J Respir Crit Care Med. 1995; 152: 725–731.
 
29.
Malhotra A, Huang Y, Fogel RB, Pillar G, Edwards JK, Kikinis R, et al. The male predisposition to pharyngeal collapse: importance of airway length. Am J Resp Crit Care Med. 2002; 166: 1388–1395.
 
30.
Smith AM, Battagel JM. Non-apneic snoring and the orthodontist: radiographic pharyngeal dimension changes with supine posture and mandibular protrusion. J Orthod. 2004; 31: 124–131.
 
eISSN:1898-2263
ISSN:1232-1966
Journals System - logo
Scroll to top