Epidemiological study on prevalent risk factors and craniofacial skeletal patterns in obstructive sleep apnea among South Indian population

Abstract

Context: Obstructive sleep apnea (OSA) is a condition affecting the upper airway among a vast number of people around the world. Aims: To determine the prevalent risk factors of OSA and its association with craniofacial skeletal pattern. Settings and Design: Cross-sectional, community-based study. Materials and Methods: In the first stage, questionnaire and physical examination were done for 1000 subjects between 20 and 70 years of age. Subjects were categorized as snorers and non-snorers. Snorers were further grouped as high-risk and low-risk snorers. In the second stage, polysomnography (PSG) was done for randomly selected high-risk subjects. Craniofacial skeletal pattern of OSA-diagnosed subjects were compared with non-OSA subjects using lateral cephalograms. Statistical Analysis: Analysis was performed using IBM SPSS 20. Independent sample t-test was used. A P value < 0.05 was considered as statistically significant. Results: The study population represented the following: high-risk snorers: 22.4%, low-risk snorers: 13.9%, and non-snorers: 63.7%. Excessive daytime sleepiness was present in 7.7%. Among high-risk, 80 underwent PSG, and 75 were diagnosed as OSA (94%) and 5 non-OSA subjects. Increased body mass index and neck circumference were statistically significant. Cephalometric evaluation showed difference in maxillomandibular relationship, narrowing of airway space, and inferiorly displaced hyoid. Conclusion: OSA is a major public health problem. Obesity is a strong predictor for OSA. Thus, high-risk subjects for sleep apnea could be identified using routine clinical examination, investigations, and anthropometric parameters.

Keywords

• craniofacial pattern
• epidemiology
• obesity
• obstructive sleep apnea
• upper airway