Enlarged tonsils, adenoids, and chronic respiratory problems have been associated with the compensatory adaptations of natural head posture (NHP) in children. Recently, it has been shown that adult patients with Obstructive Sleep Apnoea (OSA) also tend to exhibit a craniocervical extension (CCE) with a forward head posture (FHP). This study was designed to search for some characteristics of OSA patients that may be related to these adaptive changes in NHP. Overnight polysomnographic, demographic, and cephalometric records of 252 adult male subjects with various types of skeletal patterns and dental conditions were examined. Apnoea Index (AI) and Apnoea + Hypopnoea Index (AHI) variables were assessed to separate the non-apnoeic snorers (n = 35), and mild (n = 101), moderate (n = 63), and severe (n = 53) OSA groups. Results of the Tukey tests revealed that severe OSA patients had a greater tendency to exhibit a CCE with a FHP (P < or = 0.05 to P < or = 0.001). Differences in head extension (NSL.VER) between groups could not be identified. Pearson's 'r' correlation coefficients revealed that the CCE and FHP in OSA patients were associated with a higher disease severity, a longer and larger tongue, a lower hyoid bone position in relation to the mandibular plane, a smaller nasopharyngeal and a larger hypopharyngeal cross-sectional area, and a higher body mass index (P < or = 0.05 to P < or = 0.001). It is concluded that a CCE with a FHP is more likely to be seen in severe and obese OSA patients with certain morphological characteristics of the upper airway and related structures.

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A higher tongue posture can be obtained with RME in children with no reported respiratory disturbances.

Martin et al 12 have recently reported the effects of a change in the body position on Background -Snoring and obstructive sleep apnoea (OSA) are worse or may only upper airway size. Patients with OSA in the upright position had smaller upper airway occur in the supine position. The effect of body position on upper airway size has cross-sectional areas than either snorers or normal subjects, but there were no differences been reported, but the effect on tongue posture has not previously been examined. between subject groups in the supine position.Patients with OSA showed smaller decreases Methods -Detailed measurements were made of tongue posture from upright and in upper airway cross-sectional area from the upright to the supine position. Martin et al Results -In non-apnoeic snorers the be significantly influenced by gravitational forces because of the lack of a bony supporting tongue depth measurements for the superior-posterior portion of the tongue structure, we hypothesised that tongue posture would remain unchanged when awake patients were larger in the supine than in the upright position (p<0.05). There was no sig-with OSA lie down.Tongue posture in the upright and supine nificant difference in tongue depth measurements between the upright and positions was compared between patients with OSA and non-apnoeic snorers, and the effect the supine position in the patients with OSA.

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This study was undertaken to determine whether angles SNA and ANB genuinely represent both the degree of maxillary prognathism and the intermaxillary relationship in natural head position (NHP). Pearson's r correlation coefficients were used to assess the associations between these angles, and variables based on NHP and extracranial reference lines. A large sample (n=106) was used, comprising subjects with a variety of facial patterns. This was also divided into subgroups comprising subjects with similar facial configurations, determined by natural head position parameters. For the subgroups, SNA and ANB were not associated with the variables based on. NHP, and showed high variations in subjects with similar facial patterns. SNA also showed statistically significant and high correlation with the inclination of the NSL to the true vertical.