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Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea

Year 2011, Volume: 2011 Issue: 3, 244 - 251, 01.03.2011

Önder Öztürk Süleyman Hakan Tuna Hüseyin Alkış Mehmet Has Hüseyin Avni Balcıoğlu Hakan Türkkahraman Ahmet Akkaya

https://doi.org/10.5174/tutfd.2010.04093.1

Abstract

Objective: To compare the cephalometric variables of obese (body mass index (BMI) ≥30) and non-obese (BMI<30) Turkish male patients with obstructive sleep apnea syndrome (OSAS). Materials and Methods: OSAS diagnosed 85 patients who were obese [n=37; mean age (±SE), 49.41±1.54 year] and non-obese [n=48; mean age (±SE) 46.92±1.39 year] were included in the study. The cephalometric measurements and polysomnographic data of the patients were compared and a discriminatory analysis was performed. Results: The apnea-hypopnea index (AHI) was significantly higher in obese patients (p<0.01). Bimaxillary protrusion was found in obese patients (p<0.05). The non-obese patients with AHI ≥ 30 had an increased mandibular plane angle In the stepwise discriminant analysis done separately in obese and non-obese patients according to AHI; only the hyoid bone position was included in the model in obese patients and the estimated success of discrimination of AHI's level (<30 and ≥30) was 70.3%. Age, anterior face and posterior face height were included to the model in non-obese patients and the estimated success of discrimination was found as 79.2%. Conclusion: Craniofacial morphology has an effect on the severity of OSAS. If the craniofacial morphology tends toward a worsening of OSAS with obesity, the severity of the OSAS increases.

Keywords

Cephalometry obesity obstructive sleep apnea syndrome polysomnography

References

  • Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230-5. [CrossRef]
  • Tsai HH, Ho CY, Lee PL, Tan CT. Cephalometric analysis of non- obese snorers either with or without obstructive sleep apnea syn- drome. Angle Orthodon 2007;6:1054-61. [CrossRef]
  • Redline S, Tishler PV, Tosteson TD, Williamson J, Kump K, Brown- er I, et al. The familial aggregation of obstructive sleep apnea. Am J Respir Crit Care Med 1995;151:682-7.
  • Sforza E, Bacon W, Weiss T, Thibault A, Petiau C, Krieger J. Upper airway collapsibility and cephalometric variables in pa- tients with obstructive sleep apnea. Am J Respir Crit Care Med 2000;161:347-52.
  • Battagel JM, Johal A. A cephalometric comparison of normal weight and obese subjects with obstructive sleep apnoea. Radi- ography 2000;6:283-92. [CrossRef]
  • Pracharktam N, Nelson S, Hans MG, Broadbent BH, Redline S, Rosen- berg C, et al. Cephalometric assessment in obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1996;109:410-9. [CrossRef]
  • Baik UB, Suzuki M, Ikeda K, Sugawara J, Mitani H. Relationship between cephalometric characteristics and obstructive sites in ob- structive sleep apnea syndrome. Angle Orthod 2002;72:124-34.
  • Ferguson KA, Ono T, Lowe AA, Ryan CF, Fleetham JA. The rela- tionship between obesity and craniofacial structure in obstructive sleep apnea. Chest 1995;108:375-81. [CrossRef]
  • Nelson S, Hans M. Contribution of craniofacial risk factors in increasing apneic activity among obese and nonobese habitual snorers. Chest 1997;111:154-62. [CrossRef]
  • Sakakibara H, Tong M, Matsushita K, Hirata M, Konishi Y, Suetsugu S. Cephalometric abnormalities in non-obese and obese patients with obstructive sleep apnoea. Eur Respir J 1999;13:403-10. [CrossRef]
  • Partinen M, Guilleminault C, Quera-Salva MA, Jamieson A. Ob- structive sleep apnea and cephalometric roentgenograms. The role of anatomic upper airway abnormalities in the definition of abnormal breathing during sleep. Chest 1988;93:1199-205. [CrossRef]
  • Tsai HH, Ho CY, Lee PL, Tan CT. Sex differences in anthropomet- ric and cephalometric characteristics in the severity of obstruc- tive sleep apnea syndrome. Am J Orthod Dentofacial Orthop 2009;135:155-64. [CrossRef]
  • Isono S, Remmers JE, Tanaka A, Sho Y, Sato J, Nishino T. Anat- omy of pharynx in patients with obstructive sleep apnea and in normal subjects. J Appl Physiol 1997;82:1319-26.
  • Yu X, Fujimoto K, Urushibata K, Matsuzawa Y, Kubo K. Cephalo- metric analysis in obese and nonobese patients with obstructive sleep apnea syndrome. Chest 2003;124:212-8. [CrossRef]
  • Li KK, Powell NB, Kushida C, Riley RW, Adornato B, Guilleminault C. A comparison of Asian and white patients with obstructive sleep apnea syndrome. Laryngoscope 1999;109:1937-40. [CrossRef]
  • World Health Organization. Obesity: preventing and managing the global epidemic. World Health Organization, Geneva. 1997.
  • Sleep-related breathing disorders in adults: recommendations forsyndrome definition and measurement techniques in clinical- research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22:667-89.
  • Revicki DA, Israel RG. Relationship between body mass indices and measures of body adiposity. Am J Public Health 1986;76:992-4. [CrossRef]
  • Ağargün MY, Çilli AS, Kara H, Bilici M, Telcioğlu M, Semiz ÜB ve ark. Epwort uykululuk ölçeği ‘nin geçerliği ve güvenirliği. Türk Psikiyatri Dergisi 1999;10:261-7.
  • Rechtschaffen A, Kales A. A manual of standardized terminol- ogy, techniques and scoring system for sleep stages of human subjects. In: Rechtschaffen A, Kales A, eds. National Institute of Health Publication, Washington DC: US Government Printing Office;1968.p.1-12.
  • Redline S, Tishler PV, Hans MG, Tosteson TD, Strohl KP, Spry K. Ra- cial differences in sleep-disordered breathing in African Americans and Caucasians. Am J Respir Crit Care Med 1997;155:186-92.
  • Berger G, Berger R, Oksenberg A. Progression of snoring and obstructive sleep apnoea: the role of increasing weight and time. Eur Respir J 2009;33:338-45. [CrossRef]
  • Yagi H, Nakata S, Tsuge H, Yasuma F, Noda A, Morinaga M, et al. Morphological examination of upper airway in obstructive sleep apnea. Auris Nasus Larynx 2009;36:444-9. [CrossRef]
  • Tsai WH, Remmers JE, Brant R, Flemons WW, Davies J, Macar- thur C. A decision rule for diagnostic testing in obstructive sleep apnea. Am J Respir Crit Care Med 2003;167:1427-32. [CrossRef]
  • Dahlqvist J, Dahlqvist A, Marklund M, Berggren D, Stenlund H, Franklin KA. Physical findings in the upper airways related to obstructive sleep apnea in men and women. Acta Otolaryngol 2007;127:623-30. [CrossRef]
  • Watanabe T, Isono S, Tanaka A, Tanzawa H, Nishino T. Contribu- tion of body habitus and craniofacial characteristics to segmental closing pressures of the passive pharynx in patients with sleep- disordered breathing. Am J Respir Crit Care Med 2002;165:260-5. [CrossRef]
  • Verin E, Tardif C, Buffet X, Marie JP, Lacoume Y, Andrieu-Guit- rancourt J, et al. Comparison between anatomy and resistance of upper airway in normal subjects, snorers and OSAS patients. Respir Physiol 2002;129:335-43. [CrossRef]
  • Miles PG, Vig PS, Weyant RJ, Forrest TD, Rockette HE Jr. Cranio- facial structure and obstructive sleep apnea syndrome-a quali- tative analysis and meta-analysis of the literature. Am J Orthod Dentofacial Orthop 1996;109:163-72. [CrossRef]
  • Lee JJ, Ramirez SG, Will MJ. Gender and racial variations in ceph- alometric analysis. Otolaryngol Head Neck Surg 1997;117:326-9. [CrossRef]
  • Ishiguro K, Kobayashi T, Kitamura N, Saito C. Relationship be- tween severity of sleep-disordered breathing and craniofacial morphology in Japanese male patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:343-9. [CrossRef]
  • Sadeghianrizi A, Forsberg CM, Marcus C, Dahllöf G. Craniofacial development in obese adolescents. Eur J Orthod 2005;27:550-5.
  • Thilander B, Persson M, Adolfsson U. Roentgen-cephalometric standards for a Swedish population. A longitudinal study be- tween the ages of 5 and 31 years. Eur J Orthod 2005;27:370-89. [CrossRef]
  • Brander PE, Mortimore IL, Douglas NJ. Effect of obesity and erect/ supine posture on lateral cephalometry: relationship to sleep-disor- dered breathing. Eur Respir J 1999;13:398-402. [CrossRef]
  • Cistulli PA. Craniofacial abnormalities in obstructive sleep ap- noea: implications for treatment. Respirology 1996;1:167-74. [CrossRef]

Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea

Year 2011, Volume: 2011 Issue: 3, 244 - 251, 01.03.2011

Önder Öztürk Süleyman Hakan Tuna Hüseyin Alkış Mehmet Has Hüseyin Avni Balcıoğlu Hakan Türkkahraman Ahmet Akkaya

https://doi.org/10.5174/tutfd.2010.04093.1

Abstract

References

  • Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230-5. [CrossRef]
  • Tsai HH, Ho CY, Lee PL, Tan CT. Cephalometric analysis of non- obese snorers either with or without obstructive sleep apnea syn- drome. Angle Orthodon 2007;6:1054-61. [CrossRef]
  • Redline S, Tishler PV, Tosteson TD, Williamson J, Kump K, Brown- er I, et al. The familial aggregation of obstructive sleep apnea. Am J Respir Crit Care Med 1995;151:682-7.
  • Sforza E, Bacon W, Weiss T, Thibault A, Petiau C, Krieger J. Upper airway collapsibility and cephalometric variables in pa- tients with obstructive sleep apnea. Am J Respir Crit Care Med 2000;161:347-52.
  • Battagel JM, Johal A. A cephalometric comparison of normal weight and obese subjects with obstructive sleep apnoea. Radi- ography 2000;6:283-92. [CrossRef]
  • Pracharktam N, Nelson S, Hans MG, Broadbent BH, Redline S, Rosen- berg C, et al. Cephalometric assessment in obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1996;109:410-9. [CrossRef]
  • Baik UB, Suzuki M, Ikeda K, Sugawara J, Mitani H. Relationship between cephalometric characteristics and obstructive sites in ob- structive sleep apnea syndrome. Angle Orthod 2002;72:124-34.
  • Ferguson KA, Ono T, Lowe AA, Ryan CF, Fleetham JA. The rela- tionship between obesity and craniofacial structure in obstructive sleep apnea. Chest 1995;108:375-81. [CrossRef]
  • Nelson S, Hans M. Contribution of craniofacial risk factors in increasing apneic activity among obese and nonobese habitual snorers. Chest 1997;111:154-62. [CrossRef]
  • Sakakibara H, Tong M, Matsushita K, Hirata M, Konishi Y, Suetsugu S. Cephalometric abnormalities in non-obese and obese patients with obstructive sleep apnoea. Eur Respir J 1999;13:403-10. [CrossRef]
  • Partinen M, Guilleminault C, Quera-Salva MA, Jamieson A. Ob- structive sleep apnea and cephalometric roentgenograms. The role of anatomic upper airway abnormalities in the definition of abnormal breathing during sleep. Chest 1988;93:1199-205. [CrossRef]
  • Tsai HH, Ho CY, Lee PL, Tan CT. Sex differences in anthropomet- ric and cephalometric characteristics in the severity of obstruc- tive sleep apnea syndrome. Am J Orthod Dentofacial Orthop 2009;135:155-64. [CrossRef]
  • Isono S, Remmers JE, Tanaka A, Sho Y, Sato J, Nishino T. Anat- omy of pharynx in patients with obstructive sleep apnea and in normal subjects. J Appl Physiol 1997;82:1319-26.
  • Yu X, Fujimoto K, Urushibata K, Matsuzawa Y, Kubo K. Cephalo- metric analysis in obese and nonobese patients with obstructive sleep apnea syndrome. Chest 2003;124:212-8. [CrossRef]
  • Li KK, Powell NB, Kushida C, Riley RW, Adornato B, Guilleminault C. A comparison of Asian and white patients with obstructive sleep apnea syndrome. Laryngoscope 1999;109:1937-40. [CrossRef]
  • World Health Organization. Obesity: preventing and managing the global epidemic. World Health Organization, Geneva. 1997.
  • Sleep-related breathing disorders in adults: recommendations forsyndrome definition and measurement techniques in clinical- research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22:667-89.
  • Revicki DA, Israel RG. Relationship between body mass indices and measures of body adiposity. Am J Public Health 1986;76:992-4. [CrossRef]
  • Ağargün MY, Çilli AS, Kara H, Bilici M, Telcioğlu M, Semiz ÜB ve ark. Epwort uykululuk ölçeği ‘nin geçerliği ve güvenirliği. Türk Psikiyatri Dergisi 1999;10:261-7.
  • Rechtschaffen A, Kales A. A manual of standardized terminol- ogy, techniques and scoring system for sleep stages of human subjects. In: Rechtschaffen A, Kales A, eds. National Institute of Health Publication, Washington DC: US Government Printing Office;1968.p.1-12.
  • Redline S, Tishler PV, Hans MG, Tosteson TD, Strohl KP, Spry K. Ra- cial differences in sleep-disordered breathing in African Americans and Caucasians. Am J Respir Crit Care Med 1997;155:186-92.
  • Berger G, Berger R, Oksenberg A. Progression of snoring and obstructive sleep apnoea: the role of increasing weight and time. Eur Respir J 2009;33:338-45. [CrossRef]
  • Yagi H, Nakata S, Tsuge H, Yasuma F, Noda A, Morinaga M, et al. Morphological examination of upper airway in obstructive sleep apnea. Auris Nasus Larynx 2009;36:444-9. [CrossRef]
  • Tsai WH, Remmers JE, Brant R, Flemons WW, Davies J, Macar- thur C. A decision rule for diagnostic testing in obstructive sleep apnea. Am J Respir Crit Care Med 2003;167:1427-32. [CrossRef]
  • Dahlqvist J, Dahlqvist A, Marklund M, Berggren D, Stenlund H, Franklin KA. Physical findings in the upper airways related to obstructive sleep apnea in men and women. Acta Otolaryngol 2007;127:623-30. [CrossRef]
  • Watanabe T, Isono S, Tanaka A, Tanzawa H, Nishino T. Contribu- tion of body habitus and craniofacial characteristics to segmental closing pressures of the passive pharynx in patients with sleep- disordered breathing. Am J Respir Crit Care Med 2002;165:260-5. [CrossRef]
  • Verin E, Tardif C, Buffet X, Marie JP, Lacoume Y, Andrieu-Guit- rancourt J, et al. Comparison between anatomy and resistance of upper airway in normal subjects, snorers and OSAS patients. Respir Physiol 2002;129:335-43. [CrossRef]
  • Miles PG, Vig PS, Weyant RJ, Forrest TD, Rockette HE Jr. Cranio- facial structure and obstructive sleep apnea syndrome-a quali- tative analysis and meta-analysis of the literature. Am J Orthod Dentofacial Orthop 1996;109:163-72. [CrossRef]
  • Lee JJ, Ramirez SG, Will MJ. Gender and racial variations in ceph- alometric analysis. Otolaryngol Head Neck Surg 1997;117:326-9. [CrossRef]
  • Ishiguro K, Kobayashi T, Kitamura N, Saito C. Relationship be- tween severity of sleep-disordered breathing and craniofacial morphology in Japanese male patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:343-9. [CrossRef]
  • Sadeghianrizi A, Forsberg CM, Marcus C, Dahllöf G. Craniofacial development in obese adolescents. Eur J Orthod 2005;27:550-5.
  • Thilander B, Persson M, Adolfsson U. Roentgen-cephalometric standards for a Swedish population. A longitudinal study be- tween the ages of 5 and 31 years. Eur J Orthod 2005;27:370-89. [CrossRef]
  • Brander PE, Mortimore IL, Douglas NJ. Effect of obesity and erect/ supine posture on lateral cephalometry: relationship to sleep-disor- dered breathing. Eur Respir J 1999;13:398-402. [CrossRef]
  • Cistulli PA. Craniofacial abnormalities in obstructive sleep ap- noea: implications for treatment. Respirology 1996;1:167-74. [CrossRef]
There are 34 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Önder Öztürk This is me

Süleyman Hakan Tuna This is me

Hüseyin Alkış This is me

Mehmet Has This is me

Hüseyin Avni Balcıoğlu This is me

Hakan Türkkahraman This is me

Ahmet Akkaya This is me

Publication Date March 1, 2011
Published in Issue Year 2011 Volume: 2011 Issue: 3

Cite

APA Öztürk, Ö., Tuna, S. H., Alkış, H., Has, M., et al. (2011). Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea. Balkan Medical Journal, 2011(3), 244-251. https://doi.org/10.5174/tutfd.2010.04093.1
AMA Öztürk Ö, Tuna SH, Alkış H, Has M, Balcıoğlu HA, Türkkahraman H, Akkaya A. Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea. Balkan Medical Journal. March 2011;2011(3):244-251. doi:10.5174/tutfd.2010.04093.1
Chicago Öztürk, Önder, Süleyman Hakan Tuna, Hüseyin Alkış, Mehmet Has, Hüseyin Avni Balcıoğlu, Hakan Türkkahraman, and Ahmet Akkaya. “Comparison of Cephalometric Variables in Non-Obese and Obese Patients With Obstructive Sleep Apnea”. Balkan Medical Journal 2011, no. 3 (March 2011): 244-51. https://doi.org/10.5174/tutfd.2010.04093.1.
EndNote Öztürk Ö, Tuna SH, Alkış H, Has M, Balcıoğlu HA, Türkkahraman H, Akkaya A (March 1, 2011) Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea. Balkan Medical Journal 2011 3 244–251.
IEEE Ö. Öztürk, S. H. Tuna, H. Alkış, M. Has, H. A. Balcıoğlu, H. Türkkahraman, and A. Akkaya, “Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea”, Balkan Medical Journal, vol. 2011, no. 3, pp. 244–251, 2011, doi: 10.5174/tutfd.2010.04093.1.
ISNAD Öztürk, Önder et al. “Comparison of Cephalometric Variables in Non-Obese and Obese Patients With Obstructive Sleep Apnea”. Balkan Medical Journal 2011/3 (March 2011), 244-251. https://doi.org/10.5174/tutfd.2010.04093.1.
JAMA Öztürk Ö, Tuna SH, Alkış H, Has M, Balcıoğlu HA, Türkkahraman H, Akkaya A. Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea. Balkan Medical Journal. 2011;2011:244–251.
MLA Öztürk, Önder et al. “Comparison of Cephalometric Variables in Non-Obese and Obese Patients With Obstructive Sleep Apnea”. Balkan Medical Journal, vol. 2011, no. 3, 2011, pp. 244-51, doi:10.5174/tutfd.2010.04093.1.
Vancouver Öztürk Ö, Tuna SH, Alkış H, Has M, Balcıoğlu HA, Türkkahraman H, Akkaya A. Comparison of Cephalometric Variables in Non-obese and Obese Patients with Obstructive Sleep Apnea. Balkan Medical Journal. 2011;2011(3):244-51.