title: Craniofacial phenotyping for prediction of obstructive sleep apnoea in a Chinese population.
abstract: Craniofacial morphology is a risk factor for obstructive sleep apnoea (OSA). Facial photography has previously shown utility in predicting OSA in a Caucasian sleep clinic. However, ethnic differences in OSA risk factors may influence these facial predictors. Our aim was to assess phenotypical facial measurements for OSA prediction in a Chinese population.
  
  
  
  Calibrated frontal and profile facial photographs were taken before polysomnography. Photographs were analysed to derive head, face and neck measurements. Demographical, anthropometrical and facial photographical variables were considered in prediction models for OSA. OSA prediction models were derived using logistic regression and classification and regression tree techniques.
  
  
  
  Two-hundred subjects were recruited (146 OSA, 54 controls). The OSA group contained more men (77% vs 61%) and were more obese. Logistic regression modelling found cervicomental angle (OR 1.06/degree, 95% CI: 1.03-1.09, P < 0.001) and face width (OR 1.7/cm, 95% CI: 1.1-2.7, P = 0.02) predicted OSA (area under the receiver operating characteristics curve 0.76). Classification and regression tree analysis identified cricomental space area, mandibular width, mandibular plane angle and neck soft tissue area as predictors (area under receiver operating characteristics curve 0.81).
  
  
  
  In a Hong Kong Chinese sleep clinic, facial photographical measurements had predictive utility for OSA. Prediction models had similar accuracy and included variables to a previous Caucasian population.
authors.affiliation: Department of Respiratory and Sleep Medicine, Royal North Shore Hospital.|Sydney Medical School, University of Sydney.|Woolcock Institute of Medical Research, University of Sydney.
authors.forename: Kate
authors.initials: K
authors.lastname: Sutherland
authors.affiliation: Woolcock Institute of Medical Research, University of Sydney.|Department of Respiratory Medicine, Gosford Hospital, Gosford and School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.
authors.forename: Richard W W
authors.initials: RW
authors.lastname: Lee
authors.affiliation: Department of Statistics, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Petocz
authors.affiliation: Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Tat On
authors.initials: TO
authors.lastname: Chan
authors.affiliation: Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Susanna
authors.initials: S
authors.lastname: Ng
authors.affiliation: Division of Respiratory Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
authors.forename: David S
authors.initials: DS
authors.lastname: Hui
authors.affiliation: Department of Respiratory and Sleep Medicine, Royal North Shore Hospital.|Sydney Medical School, University of Sydney.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cistulli
mesh_terms: D000328:Adult; D000886:Anthropometry / Q000379:methods*; D044466:Asian People; D002508:Cephalometry / Q000379:methods*; D005145:Face; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D009765:Obesity / Q000150:complications; D010781:Photography / Q000379:methods; D017286:Polysomnography / Q000379:methods; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology
keywords: craniofacial morphology; facial phenotype; obstructive sleep apnoea; photogrammetry; prediction