0
Original Research: Sleep Disorders |

Oropharyngeal Crowding Closely Relates to Aggravation of OSA

Eiki Ito, MD, PhD; Satoru Tsuiki, DDS, PhD; Keiko Maeda, DDS, PhD; Isa Okajima, PhD; Yuichi Inoue, MD, PhD
Author and Funding Information

FUNDING/SUPPORT: Part of the present study was supported by the Japanese Society for the Promotion of Science KAKENHI [Grant 25461180] awarded to Dr Ito, 25515010 and 15H05301 awarded to Dr Tsuiki), and 25515009 awarded to Dr Inoue.

aJapan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan

bYoyogi Sleep Disorder Center, Tokyo, Japan

cDepartment of Somnology, Tokyo Medical University, Tokyo, Japan

dFaculty of Human Sciences, Waseda University, Saitama, Japan

CORRESPONDENCE TO: Eiki Ito, MD, PhD, Japan Somnology Center, Institute of Neuropsychiatry, 1-24-10, Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(2):346-352. doi:10.1016/j.chest.2016.03.005
Text Size: A A A
Published online

Background  Obesity is known to be an important risk factor for OSA; however, OSA can also be seen in nonobese patients with a small maxilla and/or mandible as well as in all obese patients with such features. Thus, we hypothesized that regional factors, oropharyngeal crowding associated with fat deposition, and maxillomandibular enclosure size closely related to the severity of OSA.

Methods  A total of 703 male Japanese subjects were enrolled; theywere classified into obese (BMI ≥ 30 kg/m2; n = 158) and nonobese (BMI < 30 kg/m2; n = 545) groups. Using lateral cephalometric analysis, we measured the tongue size (TG), lower face cage (LFC), and TG/LFC ratio (ie, oropharyngeal crowding) to evaluate the state of upper airway crowding. The correlations between these cephalometric measurements and BMI, age, and the apnea-hypopnea index (AHI) were evaluated.

Results  In obese subjects, the TG/LFC ratio, BMI, and TG positively correlated with AHI, whereas, in nonobese subjects, age, BMI, and TG/LFC significantly correlated with AHI. Subsequent stepwise multiple linear regression analysis revealed that the variables associated with AHI differed between obese and nonobese OSA subjects, although BMI and TG/LFC were significantly associated with AHI in both groups. In particular, the contribution of TG/LFC to AHI was larger than that of BMI in the obese group.

Conclusions  Oropharyngeal crowding is a local anatomic factor that independently relates to the severity of OSA in both obese and nonobese patients; the more crowded the upper airway, the more severe the OSA.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543