title: Facial morphology and obstructive sleep apnea.
abstract: OBJECTIVE
  This study aimed at assessing the relationship between facial morphological patterns (I, II, III, Long Face and Short Face) as well as facial types (brachyfacial, mesofacial and dolichofacial) and obstructive sleep apnea (OSA) in patients attending a center specialized in sleep disorders.
  
  
  METHODS
  Frontal, lateral and smile photographs of 252 patients (157 men and 95 women), randomly selected from a polysomnography clinic, with mean age of 40.62 years, were evaluated. In order to obtain diagnosis of facial morphology, the sample was sent to three professors of Orthodontics trained to classify patients' face according to five patterns, as follows: 1) Pattern I; 2) Pattern II; 3) Pattern III; 4) Long facial pattern; 5) Short facial pattern. Intraexaminer agreement was assessed by means of Kappa index. The professors ranked patients' facial type based on a facial index that considers the proportion between facial width and height.
  
  
  RESULTS
  The multiple linear regression model evinced that, when compared to Pattern I, Pattern II had the apnea and hypopnea index (AHI) worsened in 6.98 episodes. However, when Pattern II was compared to Pattern III patients, the index for the latter was 11.45 episodes lower. As for the facial type, brachyfacial patients had a mean AHI of 22.34, while dolichofacial patients had a significantly statistical lower index of 10.52.
  
  
  CONCLUSIONS
  Patients' facial morphology influences OSA. Pattern II and brachyfacial patients had greater AHI, while Pattern III patients showed a lower index.
authors.affiliation: Faculdade de Odontologia de Recife, Recife, Pernambuco, Brazil.
authors.forename: Anderson
authors.initials: A
authors.lastname: Capistrano
authors.affiliation: Universidade Sagrado Coração, Bauru, São Paulo, Brazil.
authors.forename: Aldir
authors.initials: A
authors.lastname: Cordeiro
authors.affiliation: Universidade Sagrado Coração, Bauru, São Paulo, Brazil.
authors.forename: Leopoldino
authors.initials: L
authors.lastname: Capelozza Filho
authors.affiliation: Cooperativa dos Odontologistas de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Veridiana Correia
authors.initials: VC
authors.lastname: Almeida
authors.affiliation: Sindicato dos Odontologistas no Estado de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Priscila Izabela de Castro E
authors.initials: PI
authors.lastname: Silva
authors.affiliation: Universidade de São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: Sandra
authors.initials: S
authors.lastname: Martinez
authors.affiliation: Universidade Sagrado Coração, Bauru, São Paulo, Brazil.
authors.forename: Renata Rodrigues
authors.initials: RR
authors.lastname: de Almeida-Pedrin
mesh_terms: D000328:Adult; D005145:Face; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis; D012904:Smiling