Abstract

Using sleep MRI, we aimed to identify static craniofacial measurements and dynamic upper airway collapse patterns associated with severe obstructive sleep apnea (OSA) during natural sleep in age and BMI matched patients.Nested case-control study.Sleep MRI images (3.0 Tesla scanner) and synchronized acoustic recording were used to observe patterns of dynamic airway collapse in subjects with mild and severe OSA. Mid-sagittal images were also used for static craniofacial measurements.15 male subjects with severe OSA (mean AHI 70.3±23 events/hour) were matched by age and BMI to 15 subjects with mild OSA (mean AHI 7.8±1.4 events/hour). Subjects were selected from a consecutive sleep MRI study cohort.Static craniofacial measurements selected a priori included measurements that represent maxillomandibular relationships and airway morphology. Axial, sagittal, and coronal views of the airway were rated for dynamic collapse at retropalatal, retroglossal, and lateral pharyngeal wall regions by blinded reviewers. Bivariate analysis was used to correlate measures associated with severity of OSA using AHI. Statistical significance was set at p < 0.01.Lateral pharyngeal wall collapse from dynamic sleep MRI (ß=51.8, p<0.001) and upper airway length from static MRI images (ß=27.2, p<0.001) positively correlated with severity of OSA.Lateral pharyngeal wall collapse and upper airway length are significantly associated with severe OSA based on sleep MRI. Assessment of these markers can be readily translated to routine clinical practice, and their identification may direct targeted surgical treatment. This article is protected by copyright. All rights reserved.

View details for DOI 10.1111/coa.12598

View details for PubMedID 26615985