Physical predictors for moderate to severe obstructive sleep apnea in snoring patients

• Published in: Sleep & breathing Vol. 18; no. 1; pp. 151 - 158
• Main Authors: Banhiran, Wish, Junlapan, Attapon, Assanasen, Paraya, Chongkolwatana, Cheerasook
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2014; Springer; Springer Nature B.V
• Subjects: Adult; Anthropometry; Biological and medical sciences; Body Height; Body Mass Index; Cephalometry; Dentistry; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Female; Fundamental and applied biological sciences. Psychology; Humans; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neck; Nervous system (semeiology, syndromes); Neurology; Original Article; Otorhinolaryngology; Pediatrics; Pneumology; Pneumology/Respiratory System; Polysomnography; Predictive Value of Tests; Respiration; Respiratory system : syndromes and miscellaneous diseases; Risk Assessment; Risk factors; Sex Factors; Sleep apnea; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - physiopathology; Sleep. Vigilance; Snoring - diagnosis; Snoring - physiopathology; Thailand; Vertebrates: nervous system and sense organs; Waist Circumference; Thailand; Thai; Predictor; Obstructive sleep apnea; Physical parameter; Sleep disordered breathing; Snoring; Human; Nervous system diseases; Sleep apnea syndrome; Respiratory disease; Sleep disorder; Sleep; Sleep wake cycle; Neurological disorder
• ISSN: 1520-9512; 1522-1709; 1522-1709
• DOI: 10.1007/s11325-013-0863-y

Purpose This study aimed to identify physical findings that may predict the presence of moderate to severe obstructive sleep apnea (OSA) in snoring patients. Methods A total of 283 subjects (165 males and 118 females) were recruited, including 217 OSA patients and 66 patients with apnea–hypopnea index (AHI) < 5 as a control group, diagnosed by level-1 polysomnography. Baseline data of patients including age, sex, weight, height, body mass index (BMI), neck circumference (NC), waist circumference (WC), neck-to-height ratio (NHtR), and waist-to-height ratio (WHtR) were recorded. Other physical parameters such as chin length (Chin1), thyromental distance, hyomental distance, cricomental distance, cricomental space (CMS), Friedman tongue position (FTP), and tonsils size were recorded by a single investigator who was blinded to the PSG results. Results The findings that were statistically different between the control group and moderate to severe OSA (AHI ≥ 15) included sex, BMI, NC, NHtR, WC, WHtR, Chin1, CM, and CMS ( p  < 0.05). However, logistic regression analysis showed that only male gender and WHtR ≥ 0.55 were the independent predictors for AHI ≥ 15 with adjusted odds ratios of 6.6 and 3.1, respectively. Conclusion Among snoring patients seeking medical consultation, male gender and WHtR of ≥ 0.55 were good predictors for moderate to severe OSA. No single head and neck finding reliably predicted this condition. In a situation with limited facilities, these data along with medical history may be helpful for prioritizing patients in order to achieve the optimal use of sleep investigation and treatment.