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Volume 09 No. 11
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Accepted Papers
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Scientific Investigations

Acoustic Pharyngometry Measurement of Minimal Cross-Sectional Airway Area Is a Significant Independent Predictor of Moderate-To-Severe Obstructive Sleep Apnea

http://dx.doi.org/10.5664/jcsm.3158

Pamela N. DeYoung, B.S.1,2; Jessie P. Bakker, Ph.D.2; Scott A. Sands, Ph.D.2; Salma Batool-Anwar, M.D., M.P.H.2; James G. Connolly2; James P. Butler, Ph.D.2; Atul Malhotra, M.D., F.A.A.S.M.1,2
1Division of Pulmonary and Critical Care, University of California San Diego, San Diego CA; 2Division of Sleep Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, MA

Study Objectives:

The current gold-standard method of diagnosing obstructive sleep apnea (OSA) is polysomnography, which can be inefficient. We therefore sought to determine a method to triage patients at risk of OSA, without using subjective data, which are prone to mis-reporting. We hypothesized that acoustic pharyngometry in combination with age, gender, and neck circumference would predict the presence of moderate-to-severe OSA.

Methods:

Untreated subjects with suspected OSA were recruited from a local sleep clinic and underwent polysomnography. We also included a control group to verify differences. While seated in an upright position and breathing through the mouth, an acoustic pharyngometer was used to measure the minimal cross-sectional area (MCA) of the upper airway at end-exhalation.

Results:

Sixty subjects were recruited (35 males, mean age 42 years, range 21-81 years; apnea-hypopnea index (AHI) 33 ± 30 events/h (mean ± standard deviation), Epworth Sleepiness Scale score 11 ± 6, body mass index 34 ± 8 kg/m2). In univariate logistic regression, MCA was a significant predictor of mild-no OSA (AHI < 15). A multivariate logistic regression model including MCA, age, gender, and neck circumference significantly predicted AHI < 15, explaining approximately one-third of the total variance (χ2(4) = 37, p < 0.01), with only MCA being a significant independent predictor (adjusted odds ratio 54, standard error 130; p < 0.01).

Conclusions:

These data suggest that independent of age, gender, and neck size, objective anatomical assessment can significantly differentiate those with mild versus moderate-to-severe OSA in a clinical setting, and may have utility as a component in stratifying risk of OSA.

Citation:

DeYoung PN; Bakker JP; Sands SA; Batool-Anwar S; Connolly JG; Butler JP; Malhotra A. Acoustic pharyngometry measurement of minimal cross-sectional airway area is a significant independent predictor of moderate-to-severe obstructive sleep apnea. J Clin Sleep Med 2013;9(11):1161-1164.




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