The relationship between craniofacial morphology and obstructive sleep apnea in whites and in African-Americans.
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.
Department of Orthodontics, School of Dentistry, Case Western Reserve University, Cleveland, Ohio, USA.
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Cakirer
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Hans
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Graham
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Aylor
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Tishler
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D000328:Adult; D017677:Age Distribution; D000368:Aged; D000886:Anthropometry; D044383:Black People / Q000235:genetics*; D016022:Case-Control Studies; D002508:Cephalometry / Q000379:methods*; D016000:Cluster Analysis; D015331:Cohort Studies; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017286:Polysomnography; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D012886:Skull / Q000033:anatomy & histology*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000235:genetics*; D001741:Black or African American