Correlation Analysis between Anthropometric Measurement and the Results of Seep Questionnaires in Patients with Obstructive Sleep Apnea

Hyo-Won Lee; Sang-Youl Lee; Mi-Kyung Ye; Seung-Gul Kang; Seon-Tae Kim; Kee-Hyung Park; Ji-Eun Kim; Seung-Heon Shin

doi:10.18787/jr.2015.22.2.96

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Lee, Lee, Ye, Kang, Kim, Park, Kim, and Shin: Correlation Analysis between Anthropometric Measurement and the Results of Seep Questionnaires in Patients with Obstructive Sleep Apnea

Original Article

J Rhinol 2015;22(2):96-102.

Published online: 10 January 2015

DOI: https://doi.org/10.18787/jr.2015.22.2.96

Correlation Analysis between Anthropometric Measurement and the Results of Seep Questionnaires in Patients with Obstructive Sleep Apnea

Hyo-Won Lee, MD¹, Sang-Youl Lee, MD¹, Mi-Kyung Ye, MD¹, Seung-Gul Kang, MD², Seon-Tae Kim, MD³, Kee-Hyung Park, MD⁴, Ji-Eun Kim, MD⁵, Seung-Heon Shin, MD^1,

¹ Department of Otorhinolaryngology, School of Medicine, Catholic University of Daegu, Daegu;

² Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon;

³ Department of Otolaryngology, Gil Medical Center, Gachon University, School of Medicine, Incheon;

⁴ Department of neurology, Gachon University, Gil Medical Center, Incheon;

⁵ Department of neurology, Catholic University of Daegu School of Medicine, Daegu, Korea

교신저자：신승헌, 42472 대구광역시 남구 두류공원로17길 33 대구가톨릭대학교 의과대학 이비인후과학교실Tel: +82-53-650-4530, Fax: +82-53-650-4533, E-mail: hsseung@cu.ac.kr

Received 1 July 2015 Revised 2 September 2015 Accepted 27 October 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Objectives

Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing and affects quality of life. Several questionnaires have been developed for screening OSA. The aim of this study was to compare the anthropometric measurements of OSA patients using sleep questionnaires as a tool to screen patients with OSA.

Materials and Method

This study enrolled 126 adult OSA patients. All subjects underwent overnight polysomnography (PSG) and were measured for body mass index (BMI), neck circumference, waist circumference, and tonsil size. Patients were screened using the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin questionnaire (Berlin Q), and STOP questionnaire (STOP Q). Correlation and multiple regression analyses were conducted to determine the predictive value of the anthropometric measurements of OSA patients.

Results

ESS, Berlin Q, and STOP Q results were associated with apnea hypopnea index (AHI), minimal oxygen saturation of PSG and BMI, neck circumference, waist circumference, and hip circumference of OSA patients. However, facial contour did not significantly influence the results of sleep questionnaires.

Conclusion

Some anthropometric characteristics are associated with sleep questionnaire results. Not only sleep questionnaires, but also anthropometric data can be used as predictive tools of OSA.

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Keywords: Obstructive sleep apnea, Sleep questionnaire, Polysomnography, Body mass index.

References

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Fig. 1.

Measurement of the face. A: Length from nasion to sub-nasale. B: Distance from subnasale to stomion. C: Distance from stomion to menton. D: Distacne from gonion to menton. E: Distance from cervicale to menton. F: Distance from menton to ideal menton.

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Table 1.

Anthropometric characteristics of obstructive sleep apnea patients

Variables	Mean± SD
Height (cm)	171.3±9.4
Weight (kg)	75.3±12.7
Body mass index (kg/cm²)	26.2±3.5
Neck circumference (cm)	38.5±3.5
Sitting positon	39.3±3.7
Supine position	91.0±7.6
Waist circumference (cm)	97.7±5.8
Hip circumference (cm)
Measurement of the face (mm)
Distance from nasion to subnasion	48.2±6.1
Distance from subnasion to stomion	27.0±3.0
Distance from stomion to menton	47.2±5.3
Distance from gonion to menton	94.4±12.9
Distance from cervicale to menton	3.0±2.1
Distance from menton to ideal menton	49.1±8.9
Interincisal distance	2.4±1.7
Tonsil grade	1.6±0.8
Modified Mallampati score	2.5±0.8

SD: standard deviation

Table 2.

The correlation of polysomnographic results, physical characteristics and sleep questionnaires of obstructive sleep apnea patients

	ESS (γ)	PSQI (γ)	Berlin (γ)	STOP (γ)
PSG findings
AHI	0.02^* (0.23)	0.20 (0.13)	0.01^* (0.23)	0.00^* (0.32)
Minimal O2 saturation	0.03^* (0.26)	0.10 (0.16)	0.01^* (0.24)	0.37 (0.08)
Sleep efficiency	0.10 (0.17)	0.35 (0.09)	0.88 (0.01)	0.20 (0.09)
Physical findings
Tonsil size	0.34 (0.09)	0.25 (0.11)	0.78 (0.05)	0.79 (0.04)
Mallampati score	0.07 (NA)	0.74 (NA)	0.21 (NA)	0.01^* (NA)
BMI	0.04^* (0.26)	0.47 (0.07)	0.02^* (0.37)	0.04^* (0.37)
Neck C. (supine)	0.26 (0.10)	0.39 (0.09)	0.02^* (0.36)	0.01^* (0.28)
Neck C. (erect)	0.09 (0.15)	0.74 (0.03)	0.02^* (0.36)	0.01^* (0.27)
Waist C.	0.01^* (0.22)	0.77 (0.03)	0.03^* (0.28)	0.03^* (0.34)
Hip C.	0.03^* (0.25)	0.95 (0.02)	0.18 (0.11)	0.05^* (0.33)
Facial contours
Nasion to subnasale	0.01^* (0.24)	0.25 (0.11)	0.99 (0.00)	0.25 (0.12)
Subnasale to stomion	0.49 (0.06)	0.33 (0.09)	0.34 (0.09)	0.92 (0.01)
Stomion to menton	0.46 (0.07)	0.40 (0.08)	0.50 (0.06)	0.11 (0.12)
Gonion to menton	0.14 (0.13)	0.60 (0.05)	0.77 (0.02)	0.49 (0.07)
Cervicale to menton	0.97 (0.00)	0.10 (0.16)	0.20 (0.11)	0.39 (0.08)
Menton to ideal menton	0.02^* (0.21)	0.69 (0.04)	0.51 (0.06)	0.20 (0.11)
Interincisal distance	0.43 (0.07)	0.62 (0.05)	0.18 (0.11)	0.25 (0.09)
Smoking	0.88 (NA)	0.35 (NA)	0.18 (NA)	0.04^* (NA)
Alcohol	0.77 (NA)	0.10 (NA)	0.45 (NA)	0.38 (NA)

^* Statistically significant with p＜0.05. γ: correlation coefficient, ESS: epworth sleepiness scale, PSQI: Pittsburgh sleep quality index, Berlin: Berlin questionnaire, STOP: STOP questionnaire, PSG: polysomnography, AHI: apnea-hypopnea index, BMI: body mass index, C: circumference

Table 3.

Univariate analysis of the relationship of polysomnographic results, physical characteristics and Berlin, STOP OSA risk patients

	Berlin OSA risk	STOP OSA risk
PSG findings
AHI	0.01^*	0.00^*
Minimal O2 saturation	0.01^*	0.37
Sleep efficiency	0.88	0.19
Physical findings
Tonsil size	0.78	0.79
Mallampati score	0.20	0.01^*
BMI	0.02^*	0.04^*
Neck C. (supine)	0.02^*	0.01^*
Neck C. (erect)	0.02^*	0.01^*
Waist C.	0.02^*	0.03^*
Hip C.	0.07	0.05^*
Facial contours
Nasion to subnasale	0.99	0.25
Subnasale to stomion	0.34	0.92
Stomion to menton	0.50	0.11
Gonion to menton	0.77	0.49
Cervicale to menton	0.51	0.20
Menton to ideal menton	0.20	0.39
Interincisal distance	0.18	0.25
Smoking	0.18	0.00^*
Alcohol	0.45	0.74

^* Statistically significant with p＜0.05. γ: correlation coefficient, PSG: polysomnography, AHI: apnea-hypopnea index, BMI: body mass index, C: circumference

Table 4.

Multivariate analysis of the relationship of polysomnographic results, physical characteristics and Berlin, STOP OSA risk patients

	Berlin OSA risk patients		STOP OSA riskpatients
	OR (95% CI)	p-value	OR (95% CI)	p-value
AHI	1.00 (0.97, 1.04)	0.79	1.08 (0.97, 1.19)	0.18
Minimal O2 saturation	0.96 (0.90, 1.03)	0.29	NA NA
BMI	1.09 (0.80, 1.49)	0.58	1.20 (0.69, 2.08)	0.52
Neck C. (supine)	1.02 (0.58, 1.79)	0.95	1.06 (0.46, 2.41)	0.90
Neck C. (erect)	1.08 (0.58, 2.01)	0.80	1.11 (0.44, 2.81)	0.83
Waist C.	1.02 (0.90, 1.15)	0.81	0.88 (0.70, 1.11)	0.29

OR: odds ratio, CI: confidence interval, PSG: polysomnography, AHI: apnea-hypopnea index, BMI: body mass index, C: circumference

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