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Cephalometric differences in obstructive sleep apnea between obese and non-obese Korean male patients  

Hwang, Sang-Hee (Department of Dentistry, College of Medicine, Keimyung University)
Park, In-Suk (Department of Dentistry, College of Medicine, Keimyung University)
Nam, Ki-Young (Department of Dentistry, College of Medicine, Keimyung University)
Kim, Jong-Bae (Department of Dentistry, College of Medicine, Keimyung University)
Cho, Yong-Won (Department of Neurology, College of Medicine, Keimyung University)
Suh, Young-Sung (Department of Family Medicine, College of Medicine, Keimyung University)
Ahn, Byung-Hoon (Department of Otolaryngology, College of Medicine, Keimyung University)
Park, Shin-Goo (Department of Occupational & Environmental Medicine, College of Medicine, Inha University)
Park, Hyo-Sang (Department of Orthodontics, College of Dentistry, Kyungpook National University)
Publication Information
The korean journal of orthodontics / v.38, no.3, 2008 , pp. 202-213 More about this Journal
Abstract
Objective: The purpose of this study was to compare the cephalometric measurements of obese and non-obese Korean male patients with obstructive sleep apnea syndrome (OSA). Methods: Eighty-seven adults who had visited the Sleep Disorder Clinic Center in Keimyung University, Daegu, Korea were examined and evaluated with polysomnography (PSG) and lateral cephalogram. They were divided into 4 groups (non-obese simple snorers, obese simple snorers, non-obese OSA patients, obese OSA patients) according to AHI (Apnea-Hypopnea Index) and BMI (Body Mass Index). Results: The obese OSA group had the highest AHI among the 4 groups. The non-obese OSA group had a significantly steeper mandibular angle and shorter tongue length than the obese OSA group. The hyoid bone of the obese OSA group was positioned anterior and inferior as compared with the non-obese OSA group. Multiple regression analysis showed that tongue length in the obese OSA group and retroposition of hyoid bone in the non-obese OSA group were significant determinants for the severity of AHI. Conclusions: From a cephalometric point of view, the obese and non-obese pateints with OSA may be characterized by different pathogeneses. Therefore, they have to be managed by individualized treatment. For the obese OSA patients, weight control must be advised as a first choice and for the non-obese OSA patients, oral appliance, nasal CPAP, UPPP and others could be chosen according to the obstructive sites.
Keywords
BMI; OSA; Lateral cephalogram; Individualized treatment;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
Times Cited By Web Of Science : 5  (Related Records In Web of Science)
Times Cited By SCOPUS : 4
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1 Schmidt-Nowara W, Lowe A, Wiegand L, Cartwright R, Perez-Guerra F, Menn S. Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep 1995;18: 501-10   DOI   PUBMED
2 Practice parameters for the indications for polysomnography and related procedures. Polysomnography task force, American sleep disorders association standards of practice committee. Sleep 1997;20:406-22   DOI   PUBMED
3 Haraldsson PO, Carenfelt C, Diderichsen F, Nygren A, Tingvall C. Clinical Symptoms of sleep apnea syndrome and automobile accidents. ORL J Otorhinolaryngol Relat Spec 1990;52:57-62   DOI   ScienceOn
4 Parish JM, Somers VK. Obstructive sleep apnea and cardiovascular disease. Mayo Clin Proc 2004;79:1036-46   DOI   ScienceOn
5 Tangugsorn V, Krogstad O, Espeland L, Lyberg T. Obstructive sleep apnea: a canonical correlation of cephalometric and selected demographic variables in obese and nonobese patients. Angle Orthod 2001;71:23-35
6 Ono T, Lowe AA, Ferguson KA, Fleetham JA. Associations among upper airway structure, body position, and obesity in skeletal Class I male patients with obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1996;109:625-34   DOI   ScienceOn
7 Baik UB, Suzuki M, Ikeda K, Sugawara J, Mitani H. Relationship between cephalometric characteristics and obstructive sites in obstructive sleep apnea syndrome. Angle Orthod 2002;72:124-34   PUBMED
8 Ong KC, Clerk AA. Comparison of the severity of sleep disordered breathing in Asian and Caucasian patients seen at a sleep disorders center. Respir Med 1998;92:843-8   DOI   ScienceOn
9 Davies RJ, Stradling JR. The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome. Eur Respir J 1990;3:509-14   PUBMED
10 Deegan PC, McNicholas WT. Predictive value of clinical features for the obstructive sleep apnea syndrome. Eur Respir J 1996;9:117-24   DOI
11 Schwartz AR, Gold AR, Schubert N, Stryzak A, Wise RA, Permutt S, et al. Effect of weight loss on upper airway collapsibility in obstructive sleep apnea. Am Rev Respir Dis 1991;144:494-8   DOI   PUBMED   ScienceOn
12 Otsuka R, Almeida FR, Lowe AA, Ryan F. A comparison of responders and nonresponders to oral appliance therapy for the treatment of obstructive sleep apnea. Am J Orthod Dentofacial Orthop 2006;129:222-9   DOI   ScienceOn
13 George CF, Smiley A. Sleep apnea & automobile crashes. Sleep 1999;22:790-5   PUBMED
14 Finkelstein Y, Wexler D, Horowitz E, Berger G, Nachmani A, Shapiro-Feinberg M, et al. Frontal and lateral cephalometry in patients with sleep-disordered breathing. Laryngoscope 2001; 111:634-41   DOI   ScienceOn
15 Liu Y, Lowe AA, Zeng X, Fu M, Fleetham JA. Cephalometric comparisons between Chinese and Caucasian patients with obstructive sleep apnea. Am J Orthod Dentofacial Orthop 2000; 117:479-85   DOI   ScienceOn
16 Littner M, Hirshkowitz M, Davila D, Anderson WM, Kushida CA, Woodson BT, et al. Practice parameters for the use of auto- titrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome. An American Academy of Sleep Medicine report. Sleep 2002;25:143-7   DOI   PUBMED
17 Guilleminault C, Tilkian A, Dement WC. The sleep apnea syndromes. Annu Rev Med 1976;27:465-84   DOI   ScienceOn
18 Kripke DF, Ancoli-Israel S, Klauber MR, Wingard DL, Mason WJ, Mullaney DJ. Prevalence of sleep-disordered breathing in ages 40-64 years: a population-based survey. Sleep 1997;20: 65-76   DOI   PUBMED
19 Kim J, In K, Kim J, You S, Kang K, Shim J, et al. Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med 2004;170:1108-13   DOI   ScienceOn
20 American Sleep Disorders Association. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances. American Sleep Disorders Association. Sleep 1995; 18:511-3   DOI
21 Yu X, Fujimoto K, Urushibata K, Matsuzawa Y, Kubo K. Cephalometric analysis in obese and nonobese patients with obstructive sleep apnea syndrome. Chest 2003;124:212-8   DOI   ScienceOn
22 Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middleaged adults. N Engl J Med 1993;328:1230-5   DOI   ScienceOn
23 American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22:667-89   DOI   PUBMED
24 Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Rein J, Vela-Bueno A, et al. Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 2001;163:608-13   DOI   PUBMED   ScienceOn
25 deBerry-Borowiecki B, Kukwa A, Blanks RH. Cephalometric analysis for diagnosis and treatment of obstructive sleep apnea. Laryngoscope 1988;98:226-34   PUBMED
26 Miles PG, Vig PS, Weyant RJ, Forrest TD, Rockette HE Jr. Craniofacial structure and obstructive sleep apnea syndrome-a qualitative analysis and meta-analysis of the literature. Am J Orthod Dentofacial Orthop 1996;109:163-72   DOI   ScienceOn
27 Fujita S, Conway W, Zorick F, Roth T. Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 1981; 89:923-34   DOI   PUBMED
28 World Health Organization Western Pacific Region, International Association for the Study of Obesity, and International Obesity Task Force. The Asian-Pacific perspective: redefining obesity and its treatment. Geneva, Switzerland: WHO Western Pacific Region;2000
29 Hui DS, Ko FW, Chu AS, Fok JP, Chan MC, Li TS, et al. Cephalometric assessment of craniofacial morphology in Chinese patients with obstructive sleep apnoea. Respir Med 2003;97:640-6   DOI   ScienceOn
30 Partinen M, Guilleminault C, Quera-Salva MA, Jamieson A. Obstructive 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   DOI   ScienceOn
31 Guilleminault C, Quera-Salva MA, Partinen M, Jamieson A. Women and the obstructive sleep apnea syndrome. Chest 1988;93:104-9   DOI   ScienceOn
32 Tsuchiya M, Lowe AA, Pae EK, Fleetham JA. Obstructive sleep apnea subtypes by cluster analysis. Am J Orthod Dentofacial Orthop 1992;101:533-42   DOI   ScienceOn
33 Wilms D, Popovich J, Conway W, Fujita S, Zorick F. Anatomic abnormalities in obstructive sleep apnea. Ann Otol Rhinol Laryngol 1982;91:595-6   DOI   PUBMED
34 Hoffstein V, Mateika S. Differences in abdominal and neck circumferences in patients with and without obstructive sleep apnoea. Eur Respir J 1992;5:377-81
35 Li KK, Kushida C, Powell NB, Riley RW, Guilleminault C. Obstructive sleep apnea syndrome: a comparison between Far-East Asian and white men. Laryngoscope 2000;110: 1689-93   DOI   ScienceOn
36 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   DOI   ScienceOn
37 Riley R, Guilleminault C, Herran J, Powell N. Cephalometric analysis and flow-volume loops in obstructive sleep apnea patients. Sleep 1983;6:303-11   DOI   PUBMED
38 Horner RL, Mohiaddin RH, Lowell DG, Shea SA, Burman ED, Longmore DB, et al. Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnoea and weight matched controls. Eur Respir J 1989;2:613-22   PUBMED
39 Rubinstein I, Colapinto N, Rotstein LE, Brown IG, Hoffstein V. Improvement in upper airway function after weight loss in patients with obstructive sleep apnea. Am Rev Respir Dis 1988;138:1192-5   DOI   PUBMED   ScienceOn
40 Kong HW, Lee HJ, Choi YS, Rha JH, Ha CK, Hwangc DU, et al. Clinical predictors of obstructive sleep apnea. J Korean Neurol Assoc 2005;23:324-9
41 Pracharktam N, Hans MG, Strohl KP, Redline S. Upright and supine cephalometric evaluation of obstructive sleep apnea syndrome and snoring subjects. Angle Orthod 1994:64:63-73   PUBMED