Relationship between body mass index, age and upper airway measurements in snorers and sleep apnoea patients

Abstract

R Re el la at ti io on ns sh hi ip p b be et tw we ee en n b bo od dy y m ma as ss s i in nd de ex x, , a ag ge e a an nd d u up pp pe er r a ai ir rw wa ay y m me ea as su ur re em me en nt ts s i in n s sn no or re er rs s a an nd d s sl le ee ep p a ap pn no oe ea a p pa at ti ie en nt ts s ABSTRACT: Anatomical pharyngeal and craniofacial abnormalities have been reported using upper airway imaging in snorers with or without obstructive sleep apnoea (OSA). However, the influences of the age and weight of the patient on these abnormalities remain to be established. The aim of this study was, therefore, to evaluate in a large population of snorers with or without OSA, the relationship between body mass index (BMI), age and upper airway morphology. One hundred and forty patients were referred for assessment of a possible sleeprelated breathing disorder and had complete polysomnography, cephalometry and upper airway computed tomography.For the whole population, OSA patients had more upper airway abnormalities than snorers. When subdivided for BMI and age, however, only lean or younger OSA patients were significantly different from snorers as regards their upper airway anatomy. The shape of the oropharynx and hypopharynx changed significantly with BMI both in OSA patients and snorers, being more spherical in the highest BMI group due mainly to a decrease in the transverse axis. On the other hand, older patients (>63 yrs), whether snorers or apnoeics, had larger upper airways at all pharyngeal levels than the youngest group of patients (<52 yrs). For the total group of patients, upper airway variables explained 26% of the variance in apnoea/hypopnoea index (AHI), whereas in lean (BMI <27 kg·m -2 ) or youngest (age <52 yrs) subjects upper airway variables explained, respectively 69 and 55% of the variance in AHI.In conclusion, in lean or young subjects, upper airway abnormalities explain a major part of the variance in apnoea/hypopnoea index and are likely to play an important physiopathogenic role. This study also suggests that the shape of the pharyngeal lumen in awake subjects is more dependent on body mass index than on the presence of obstructive sleep apnoea. Further investigation looking at upper airway imaging for surgical selection in obstructive sleep apnoea should focus on lean and young patients. Eur Respir J., 1996Respir J., , 9, 1801Respir J., -1809

Evaluation of cross-section airway configuration of obstructive sleep apnea

“…11-14 The most common measurements used to compare the static morphology of the upper airway between OSA patients and healthy subjects (non-OSA) are the minimum surface area of the oropharyngeal region 15 and the anterior-posterior (AP) and lateral (L) dimensions of this area. [10][11]16 Other authors correlated OSA with the body mass index (BMI = kg/m 2 ) and many of them found a positive relationship between these two factors. 1,16-18 In addition to BMI it is also possible that the shape of the airway is a predictor of collapse.…”

What can anthropometric measurements tell us about obstructive sleep apnoea?

“…According to the CT study performed by Enciso et al [10], men older than 57 years and individuals having narrow upper airway measurement have been identified as a high risk group for OSA. Mayer et al [21] has also reported an increase in the width of the oropharynx in OSA patients. The long and narrow airway had increased the frequency of airway collapse [10,21,36].…”

“…In the aetiology of OSA, some of the most important parameters are the airway volume, airway length and various anthropometric measurements [1,9,10,21,36]. According to the CT study performed by Enciso et al [10], men older than 57 years and individuals having narrow upper airway measurement have been identified as a high risk group for OSA.…”

The Relationship between Obstructive Sleep Apnea and the Nasofacial Anthropometry of Sikkimese Subjects

“…In addition, severe OSAS patients had bigger neck circumference than those in the control group. Mayer P et al [24] in a study to study the Relationship between body mass index, age and upper airway measurements in snorers and sleep apnoea patients have found out that the anatomy varies with BMI. To assess a possible sleeprelated breathing disorder subjects had complete polysomnography, cephalometry and upper airway computed tomography.…”