The relationship between obesity and craniofacial structure in obstructive sleep apnea

Chest. 1995 Aug;108(2):375-81. doi: 10.1378/chest.108.2.375.


Study objective: To evaluate the interaction between craniofacial structure and obesity in male patients with obstructive sleep apnea (OSA).

Design: Retrospective analysis of a cohort of OSA patients. The relationships between neck circumference (NC), body mass index, apnea severity, and craniofacial and upper airway soft-tissue measurements from upright lateral cephalometry were examined. Patients were divided into groups; small to normal NC (group A), intermediate NC (group B), or large NC (group C).

Setting: A university teaching hospital and tertiary sleep referral center.

Patients: A consecutive series of patients with OSA who underwent polysomnography and lateral cephalometry.

Measurements and results: Group A patients were less obese and had more craniofacial abnormalities such as a smaller mandible and maxilla and a more retrognathic mandible. Group B patients had both upper airway soft-tissue and craniofacial abnormalities. Group C patients were more obese with larger tongues and soft palates, and an inferiorly placed hyoid. Group C patients also had fewer craniofacial abnormalities than group A or B patients. There was no difference in airway size among the three groups.

Conclusions: We conclude that there is a spectrum of upper airway soft-tissue and craniofacial abnormalities among OSA patients: obese patients with increased upper airway soft-tissue structures, nonobese patients with abnormal craniofacial structure, and an intermediate group of patients with abnormalities in both craniofacial structure and upper airway soft-tissue structures.

Publication types

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

MeSH terms

  • Adult
  • Analysis of Variance
  • Cephalometry / instrumentation
  • Cephalometry / methods
  • Cephalometry / statistics & numerical data
  • Facial Bones / abnormalities
  • Facial Bones / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Neck / anatomy & histology
  • Obesity / complications*
  • Polysomnography / instrumentation
  • Polysomnography / methods
  • Polysomnography / statistics & numerical data
  • Radiography
  • Retrospective Studies
  • Skull / abnormalities
  • Skull / diagnostic imaging*
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / etiology*