Gender-wise analysis of the cephalometric factors affecting obstructive sleep apnea

Sang-Hee Hwang

doi:10.4041/kjod.2011.41.3.164

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Hwang: Gender-wise analysis of the cephalometric factors affecting obstructive sleep apnea

Original Article

Korean Journal of Orthodontics

Korean Journal of Orthodontics 2011; 41(3): 164-173.

Published online: 28 June 2011

DOI: https://doi.org/10.4041/kjod.2011.41.3.164

Gender-wise analysis of the cephalometric factors affecting obstructive sleep apnea

Sang-Hee Hwang, DDS, MSD, PhD^a

^aAssistant Professor, Department of Dentistry, College of Medicine, Keimyung University, Korea.

Corresponding author: Sang-Hee Hwang. Department of Dentistry, Dongsan Medical Center, College of Medicine, Keimyung University, 194 Dongsan-dong, Jung-gu, Daegu 700-712, Korea. +82 53 250 7803; hsh99@dsmc.or.kr

Received 24 December 2010 Revised 20 February 2011 Accepted 23 February 2011

Abstract

Objective

The purpose of this study was to perform gender-wise analysis of the related cephalometric factors affecting Korean patients with obstructive sleep apnea (OSA).

Methods

We examined 118 adults who had visited the Sleep Disorder Clinic Center in Keimyung university, Daegu, Korea, and evaluated them by using polysomnography (PSG) and lateral cephalograms. The patients were divided into 4 groups (male simple snorers, male OSA patients, female simple snorers, and female OSA patients) according to AHI (apnea-hypopnea index) and sex.

Results

The position of the hyoid bone in the female OSA group was inferior to that in the female simple snorer group. Multiple regression analysis showed that tongue length and soft palate width were significant determinants for the severity of AHI in male OSA patients. However, inferior position of the hyoid was a significant determinant only in women.

Conclusions

From a cephalometric point of view, OSA in male and female adult patients may be characterized by different pathogeneses. In particular, in female OSA patients, they might be managed by individualized treatments such as hormone replacement therapy in addition to conventional treatment.

Keywords: Cephalometric factors, OSA, Gender

Figures and Tables

Fig. 1

Cephalometric landmarks. S (sella), Midpoint of the fossa hypophysealis; N (nasion), anterior point at the frontonasal suture; Ba (basion), the most posteroinferior point on the clivus; ANS (anterior nasal spine), the most anterior point on the nasal spine; PNS (posterior nasal spine), the most posterior point on the nasal spine; A, the deepest anterior point in the concavity of the anterior maxilla; B, the deepest anterior point in the concavity of the anterior mandible; Cd (condylion), the most posterosuperior point on the condylar head; Gn (gnathion), the most anteroinferior point on the chin bone; Go (gonion), a mid-point at the gonial angle located by bisecting the posterior and inferior borders of the mandible; Me (menton), the most inferior point on the chin bone; P, the inferior tip of the soft palate; H, the most anterosuperior point on the hyoid bone; V, the most anteroinferior point on the epiglottic fold; TT, the most anterior point on the tip of the tongue; C3, the most anteroinferior point on the third cervical vertebrae; MP (mandibular plane), a tangent line from Me to the inferior mandibular border; SPW, soft palatal width; PAS, posterior air way space; Nph1, nasopharyngeal air way width 1; Nph2, nasopharyngeal air way width 2; Oph1, oropharyngeal air way width 1; Oph2, oropharyngeal air way width 2.

Table 1

Cephalometric measurements

Table 2

Characteristics of subjects according to sex

All data are presented as mean ± SD, ^*p < 0.05. AHI, Apnea-hypopnea index; BMI, body mass index; Simple, simple snorers; OSA, obstructive sleep apnea patients. p-value by independent t test; ^†p-value by Mann-Whitney Test.

Table 3

Cephalometric measurements in simple snorers and obstructive sleep apnea patients according to sex

All data are presented as mean ± SD, ^*p < 0.05. p-value by independent t test; ^†p-value by Mann-Whitney Test. Simple, Simple snorers; OSA, obstructive sleep apnea patients.

Table 4

Adjusted odds ratio of obstructive sleep apnea patients in cephalometric measurements according to sex

Adjusted OR (odds ratio) was adjusted by age and BMI. CI, Confidence interval; OSA, obstructive sleep apnea patients.

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