The relationship between craniofacial morphology and obstructive sleep apnea in whites and in African-Americans

• Published in: American journal of respiratory and critical care medicine Vol. 163; no. 4; pp. 947 - 950
• Main Authors: CAKIRER, Banu, HANS, Mark G, GRAHAM, Greg, AYLOR, Joan, TISHLER, Peter V, REDLINE, Susan
• Format: Journal Article
• Language: English
• Published: New York, NY American Lung Association 01.03.2001
• Subjects: Adult; African Continental Ancestry Group - genetics; Age Distribution; Aged; Anthropometry; Biological and medical sciences; Case-Control Studies; Cephalometry - methods; Cluster Analysis; Cohort Studies; European Continental Ancestry Group - genetics; Face - anatomy & histology; Female; Humans; Incidence; Linear Models; Male; Medical sciences; Middle Aged; Multivariate Analysis; Pneumology; Polysomnography; Regression Analysis; Respiratory system : syndromes and miscellaneous diseases; Risk Factors; Severity of Illness Index; Sex Distribution; Skull - anatomy & histology; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - ethnology; United States - epidemiology; United States; Human; Sleep apnea syndrome; Respiratory disease; Anthropometry; Sleep disorder; Negroid; Exploration; Corporal biometry; Ethnic group; Phenotype; Risk factor; Craniofacial; Caucasoid; Morphometry
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/ajrccm.163.4.2005136

Previous studies of craniofacial risk factors for obstructive sleep apnea (OSA) have been based predominantly on cephalometry. However, differences in head form (measured by the cranial index [CI]) and facial form (measured by the facial index [FI]) are considered by anthropologists to provide a basis for structural variation in craniofacial anatomy. We assessed the association of head and facial form with the apnea hypopnea index (AHI) in 364 white individuals and 165 African-Americans. Data collected included cranial and facial dimensions (using anthropometric calipers), body mass index (BMI), neck circumference, and the AHI. CI and FI differed for whites with OSA (AHI > or = 15) versus those without OSA (AHI < 5) (increased CI and decreased FI in subjects with OSA, p = 0.005 and p = 0.006, respectively). CI and FI did not differ in OSA versus non-OSA groups of African-Americans. In subjects with OSA, the CI in whites was again greater and the FI smaller than those in African-Americans (p = 0.007 and p = 0.004, for CI and FI.) We conclude that brachycephaly is associated with an increased AHI in whites but not in African-Americans. The CI may useful in phenotyping and identifying population subsets with OSA.