Abstract
Objectives: The purpose of this study was to use standardized digital facial photography to investigate craniofacial and cervical characteristics of individuals with obstructive sleep apnea (OSA) and the possible associations between these characteristics and polysomnographic data. Material and methods: The final sample included 50 individuals with OSA (Apnea Hypopnea Index - AHI > 5) and 10 controls (AHI < 5). All subjects underwent a history and physical examination with measurements of anthropometric parameters and overnight polysomnographic records. Anthropometric assessment and standardized frontal-profile facial photographs were performed prior to polysomnography. Results: Higher AHI was associated with alterations in the cervical area, where the neck circumferences were significantly increased. We observed an interaction between the craniofacial and anthropometric variables with the polysomnographic variable. Specifically, when there was increased superior facial third (P=0.032), inferior facial third (P=0.039) and cervical circumference (P=0.050), there was a greater chance of having AHI over 5. Conclusions : Using craniofacial measurements in standardized photographs and anthropometric measurements, the vertical facial pattern and the neck circumference are the strongest predictors of OSA.
Highlights
Material and methodObstructive sleep apnea (OSA) is characterized by episodes with partial or total obstruction of the upper airways during sleep[1]
Higher apnea hypopnea index (AHI) was associated with alterations in the cervical area, where the neck circumferences were significantly increased
When there was increased superior facial third (P=0.032), inferior facial third (P=0.039) and cervical circumference (P=0.050), there was a greater chance of having AHI over 5
Summary
Obstructive sleep apnea (OSA) is characterized by episodes with partial or total obstruction of the upper airways during sleep[1]. This sleep disorder is often associated with snoring and obesity. Affects 2 to 4% of the population; mostly men aged 40 to 60 years[2]. The development of sophisticated diagnostic tools and the increased awareness of this disease among medical professionals and the population in general have made the diagnosis of new OSA cases more common, significantly increasing its prevalence. As well as genetic, anatomic, and hormonal factors, together with changes of ventilatory drive, interact in a diverse manner in the pathophysiology and clinical expression of this disease. The increase of the body mass index and neck circumference are strong predictors of the disease 5,6
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