Mm. Ozbek et al., NATURAL HEAD POSTURE, UPPER AIRWAY MORPHOLOGY AND OBSTRUCTIVE SLEEP-APNEA SEVERITY IN ADULTS, European journal of orthodontics, 20(2), 1998, pp. 133-143
Enlarged tonsils, adenoids, and chronic respiratory problems have been
associated with the compensatory adaptations of natural head posture
(NHP) in children. Recently, it has been shown that adult patients wit
h Obstructive Sleep Apnoea (OSA) also tend to exhibit a craniocervical
extension (CCE) with a forward head posture (FHP). This study was des
igned to search for some characteristics of OSA patients that may be r
elated to these adaptive changes in NHP. Overnight polysomnographic, d
emographic, and cephalometric records of 252 adult male subjects with
various types of skeletal patterns and dental conditions were examined
. Apnoea Index (AI) and Apnoea + Hypopnoea Index (AHI) variables were
assessed to separate the non-apnoeic snorers (n = 35), and mild (n = 1
01), moderate (n = 63), and severe (n = 53) OSA groups. Results of the
Tukey tests revealed that severe OSA patients had a greater tendency
to exhibit a CCE with a FHP (P less than or equal to 0.05 to P less th
an or equal to 0.001). Differences in head extension (NSL.VER) between
groups could not be identified. Pearson's 'r' correlation coefficient
s revealed that the CCE and FHP in OSA patients were associated with a
higher disease severity, a longer and larger tongue, a lower hyoid bo
ne position in relation to the mandibular plane, a smaller nasopharyng
eal and a larger hypopharyngeal cross-sectional area, and a higher bod
y mass index (P less than or equal to 0.05 to P less than or equal to
0.001). It is concluded that a CCE with a FHP is more likely to be see
n in severe and obese OSA patients with certain morphological characte
ristics of the upper airway and related structures.