The relationship between craniofacial morphology and obstructive sleep apnea in whites and in African-Americans

Am J Respir Crit Care Med. 2001 Mar;163(4):947-50. doi: 10.1164/ajrccm.163.4.2005136.


Previous studies of craniofacial risk factors for obstructive sleep apnea (OSA) have been based predominantly on cephalometry. However, differences in head form (measured by the cranial index [CI]) and facial form (measured by the facial index [FI]) are considered by anthropologists to provide a basis for structural variation in craniofacial anatomy. We assessed the association of head and facial form with the apnea hypopnea index (AHI) in 364 white individuals and 165 African-Americans. Data collected included cranial and facial dimensions (using anthropometric calipers), body mass index (BMI), neck circumference, and the AHI. CI and FI differed for whites with OSA (AHI > or = 15) versus those without OSA (AHI < 5) (increased CI and decreased FI in subjects with OSA, p = 0.005 and p = 0.006, respectively). CI and FI did not differ in OSA versus non-OSA groups of African-Americans. In subjects with OSA, the CI in whites was again greater and the FI smaller than those in African-Americans (p = 0.007 and p = 0.004, for CI and FI.) We conclude that brachycephaly is associated with an increased AHI in whites but not in African-Americans. The CI may useful in phenotyping and identifying population subsets with OSA.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Continental Ancestry Group / genetics*
  • Age Distribution
  • Aged
  • Anthropometry
  • Case-Control Studies
  • Cephalometry / methods*
  • Cluster Analysis
  • Cohort Studies
  • European Continental Ancestry Group / genetics*
  • Face / anatomy & histology*
  • Female
  • Humans
  • Incidence
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Polysomnography
  • Regression Analysis
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Skull / anatomy & histology*
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / ethnology*
  • United States / epidemiology