Upper airway morphology in adults with positional obstructive sleep apnea

Xiaoxin Shi*, Kate Sutherland, Frank Lobbezoo, Erwin Berkhout, Jan de Lange, Peter A. Cistulli, M. Ali Darendeliler, Oyku Dalci, Ghizlane Aarab

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Purpose: To compare the anatomical balance and shape of the upper airway in the supine position between adults with positional obstructive sleep apnea (POSA) and adults with non-positional OSA (NPOSA). Methods: Adults diagnosed with OSA (apnea-hypopnea index (AHI) > 10 events/h) were assessed for eligibility. POSA was defined as the supine AHI more than twice the AHI in non-supine positions; otherwise, patients were classified as NPOSA. Cone beam computed tomography (CBCT) imaging was performed for every participant while awake in the supine position. The anatomical balance was calculated as the ratio of the tongue size to the maxillomandibular enclosure size. The upper airway shape was calculated as the ratio of the anteroposterior dimension to the lateral dimension at the location of the minimal cross-sectional area of the upper airway (CSAmin-shape). Results: Of 47 participants (28 males, median age [interquartile range] 56 [46 to 63] years, median AHI 27.8 [15.0 to 33.8]), 34 participants were classified as having POSA (72%). The POSA group tended to have a higher proportion of males and a lower AHI than the NPOSA group (P = 0.07 and 0.07, respectively). After controlling for both sex and AHI, the anatomical balance and CSAmin-shape were not significantly different between both groups (P = 0.18 and 0.73, respectively). Conclusion: Adults with POSA and adults with NPOSA have similar anatomical balance and shape of their upper airway in the supine position. Trial registration: This study was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR Trial ACTRN12611000409976).

Original languageEnglish
Pages (from-to)193-201
Number of pages9
JournalSleep and breathing
Volume28
Issue number1
Early online date19 Jul 2023
DOIs
Publication statusPublished - Mar 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2023.

Funding

Xiaoxin Shi declares that she has no conflicts of interest. Kate Sutherland has received in kind support from SomnoMed Australia in the form of donation of oral appliances for investigator-initiated research. Frank Lobbezoo is a member of the Academic Advisory Boards for GrindCare and Oral Function of Sunstar Suisse S.A. and receives research grants from Sunstar Suisse S.A., SomnoMed, Vivisol BV, Health Holland, and Airway Management. Erwin Berkhout declares that he has no conflicts of interest. Jan de Lange declares that he has no conflicts of interest. Peter A. Cistulli holds the ResMed Chair in Sleep Medicine at the University of Sydney, established through funding from ResMed. He is a consultant to ResMed, SomnoMed, and Signifier Medical Technologies and has receive equipment support for research. M. Ali Darendeliler declares that he has no conflicts of interest. Oyku Dalci declares that she has no conflicts of interest. Ghizlane Aarab is a member of the Academic Advisory Board for Oral Function of Sunstar Suisse S.A. and receives research grants from Sunstar Suisse S.A., SomnoMed, Vivisol BV, and Health Holland. Xiaoxin Shi received a scholarship from the China Scholarship Council. This work was supported by the National Health and Medical Research Council (NHMRC) of Australia (Project grant GNT1024351).

FundersFunder number
ResMed
National Health and Medical Research CouncilGNT1024351
China Scholarship Council

    Keywords

    • Anatomical balance of the upper airway
    • Cone beam computed tomography
    • Positional obstructive sleep apnea
    • Upper airway shape

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