Abstract
We used sophisticated volumetric analysis techniques with magnetic resonance imaging in a case-control design to study the upper airway soft tissue structures in 48 control subjects (apnea-hypopnea index, 2.0 ± 1. 6 events/hour) and 48 patients with sleep apnea (apnea-hypopnea index, 43.8 ± 25.4 events/hour). Our design used exact matching on sex and ethnicity, frequency matching on age, and statistical control for craniofaclal size and visceral neck fat. The data support our a priori hypotheses that the volume of the soft tissue structures surrounding the upper airway is enlarged in patients with sleep apnea and that this enlargement is a significant risk factor for sleep apnea. After covariate adjustments the volume of the lateral pharyngeal walls (p < 0.0001), tongue (p < 0.0001), and total soft tissue (p < 0.0001) was significantly larger in subjects with sleep apnea than in normal subjects. These data also demonstrated, after covariate adjustments, significantly increased risk of sleep apnea the larger the volume of the tongue, lateral pharyngeal walls, and total soft tissue: (1) total lateral pharyngeal wall (odds ratio [OR], 6.01; 95% confidence interval [CI], 2.62-17.14); (2) total tongue (OR, 4.66; 95% CI, 2.31-10.95); and (3) total soft tissue (OR, 6.95; 95% CI, 3.08-19.11). In a multivariable logistic regression analysis the volume of the tongue and lateral walls was shown to independently increase the risk of sleep apnea.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 522-530 |
| Number of pages | 9 |
| Journal | American Journal of Respiratory and Critical Care Medicine |
| Volume | 168 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 1 2003 |
| Externally published | Yes |
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Keywords
- Lateral pharyngeal walls
- Magnetic resonance imaging
- Obstructive sleep apnea
- Parapharyngeal fat pads
- Upper airway
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging. / Schwab, Richard J.; Pasirstein, Michael; Pierson, Robert; Mackley, Adonna; Hachadoorian, Robert; Arens, Raanan; Maislin, Greg; Pack, Allan I.
In: American Journal of Respiratory and Critical Care Medicine, Vol. 168, No. 5, 01.09.2003, p. 522-530.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging
AU - Schwab, Richard J.
AU - Pasirstein, Michael
AU - Pierson, Robert
AU - Mackley, Adonna
AU - Hachadoorian, Robert
AU - Arens, Raanan
AU - Maislin, Greg
AU - Pack, Allan I.
PY - 2003/9/1
Y1 - 2003/9/1
N2 - We used sophisticated volumetric analysis techniques with magnetic resonance imaging in a case-control design to study the upper airway soft tissue structures in 48 control subjects (apnea-hypopnea index, 2.0 ± 1. 6 events/hour) and 48 patients with sleep apnea (apnea-hypopnea index, 43.8 ± 25.4 events/hour). Our design used exact matching on sex and ethnicity, frequency matching on age, and statistical control for craniofaclal size and visceral neck fat. The data support our a priori hypotheses that the volume of the soft tissue structures surrounding the upper airway is enlarged in patients with sleep apnea and that this enlargement is a significant risk factor for sleep apnea. After covariate adjustments the volume of the lateral pharyngeal walls (p < 0.0001), tongue (p < 0.0001), and total soft tissue (p < 0.0001) was significantly larger in subjects with sleep apnea than in normal subjects. These data also demonstrated, after covariate adjustments, significantly increased risk of sleep apnea the larger the volume of the tongue, lateral pharyngeal walls, and total soft tissue: (1) total lateral pharyngeal wall (odds ratio [OR], 6.01; 95% confidence interval [CI], 2.62-17.14); (2) total tongue (OR, 4.66; 95% CI, 2.31-10.95); and (3) total soft tissue (OR, 6.95; 95% CI, 3.08-19.11). In a multivariable logistic regression analysis the volume of the tongue and lateral walls was shown to independently increase the risk of sleep apnea.
AB - We used sophisticated volumetric analysis techniques with magnetic resonance imaging in a case-control design to study the upper airway soft tissue structures in 48 control subjects (apnea-hypopnea index, 2.0 ± 1. 6 events/hour) and 48 patients with sleep apnea (apnea-hypopnea index, 43.8 ± 25.4 events/hour). Our design used exact matching on sex and ethnicity, frequency matching on age, and statistical control for craniofaclal size and visceral neck fat. The data support our a priori hypotheses that the volume of the soft tissue structures surrounding the upper airway is enlarged in patients with sleep apnea and that this enlargement is a significant risk factor for sleep apnea. After covariate adjustments the volume of the lateral pharyngeal walls (p < 0.0001), tongue (p < 0.0001), and total soft tissue (p < 0.0001) was significantly larger in subjects with sleep apnea than in normal subjects. These data also demonstrated, after covariate adjustments, significantly increased risk of sleep apnea the larger the volume of the tongue, lateral pharyngeal walls, and total soft tissue: (1) total lateral pharyngeal wall (odds ratio [OR], 6.01; 95% confidence interval [CI], 2.62-17.14); (2) total tongue (OR, 4.66; 95% CI, 2.31-10.95); and (3) total soft tissue (OR, 6.95; 95% CI, 3.08-19.11). In a multivariable logistic regression analysis the volume of the tongue and lateral walls was shown to independently increase the risk of sleep apnea.
KW - Lateral pharyngeal walls
KW - Magnetic resonance imaging
KW - Obstructive sleep apnea
KW - Parapharyngeal fat pads
KW - Upper airway
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UR - http://www.scopus.com/inward/citedby.url?scp=0042376069&partnerID=8YFLogxK
U2 - 10.1164/rccm.200208-866OC
DO - 10.1164/rccm.200208-866OC
M3 - Article
VL - 168
SP - 522
EP - 530
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 5
ER -