High Mallampati score and nasal obstruction are associated risk factors for obstructive sleep apnoea

Abstract

Induced nasal obstruction can cause obstructive apnoeas in healthy subjects during sleep, but the relationship between nasal resistance measured during wakefulness and obstructive sleep apnoea syndrome (OSAS) is weak. It was postulated that if the subjects could not breathe through the nose, the oral airway must be used, but if this airway is narrowed as well, then it could precipitate sleep-disordered breathing (SDB).Nasal patency, Mallampati score (MS), neck circumference and body mass index were measured in 202 subjects referred to the authors9 hospital to undergo a full-night polysomnography for suspicion of SDB.A significant correlation was found between the MS and apnoea/hypopnoea index measured during sleep. However, the relationship between these parameters was only significant in patients with nasal obstruction. The relative risk of having OSAS with a MS of III or IV was 1.95 for the whole group and 2.45 in patients with nasal obstruction.In conclusion, a high Mallampati score represents a predisposing factor for obstructive sleep apnoea syndrome, especially if it is associated with nasal obstruction. These patients merit special attention from both the sleep physician and the anaesthetist.

Obstrução nasal e alto escore de Mallampati como fatores de risco associados para Apneia Obstrutiva do Sono

“…By the same token, the association of SOAS and nasal obstruction has been broadly studied in the last two decades 18 . Udaka et al 19 showed, by means of a populational study with 4,818 patients, a positive correlation between nasal obstruction, daytime sleepiness and sleep apnea.…”

“…Patients with such conditions have two important obstruction points, increasing SOAS severity because the patient would put up a greater chest stress in order to overcome two levels of obstruction 18 . We observed that in a series of patients with High Mallampati score, that it is an important isolated risk factor for apnea appearance and worsening.…”

The Kushida Index as a screening tool for obstructive sleep apnoea-hypopnoea syndrome

“…19 However, even without nasal obstruction, those with a Mallampati score of 3 or 4 have been reported to have a 1.95 relative risk of having OSAHS. 22 The Mallampati score could be easily carried out by dentists as part of a screening procedure, but in our study a high Mallampati score was not correlated to a diagnosis of OSAHS.…”

“…24,25 The use of the Mallampati score was based on the results of three studies of the use of this score as a clinical predictor for OSAHS. [19][20][21][22][23] Participants all had limited sleep studies (respiratory polysomnography) carried out using the Somnoscreen system (S-Med, UK) and manually analysed by a sleep technician (DM). The diagnosis of OSAHS was based on the daytime somnolence (an Epworth Sleepiness score ≥10) and an oxygen de-saturation index ≥10/hr).…”

Edentulism and Obstructive Sleep Apnea: A Case Report

“…Reported risk factors include obesity, increased neck circumference, male sex and anatomical abnormalities of the face [1,[8][9][10][11][12][13][14].…”