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Anthropometric 3D evaluation of the face in patients with sleep related breathing disorders

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

To evaluate craniofacial measurements on 3D-stereophotogrammetry and see if particular measurements are more typical in obstructive sleep apnea (OSA) and have a correlation with its severity.

Methods

Subjects included were adults undergoing a diagnostic polysomnography. Age, BMI, neck, abdominal and hip circumference (cm) were recorded.

3D-stereophotogrammetry was performed and landmarks were placed on the 3D-image. Different linear, angular and volume measurements were performed to gauge facial and neck anatomy. The relationship between these measurements and the severity of OSA, based on the obstructive apnea/hypopnea index (OAHI, events/h), was assessed by multiple linear regression, and adjusted for BMI and sex.

Results

Of 91 subjects included (61 male), mean age was 46 ± 12 years, BMI 30.1 ± 6.5 kg/m2, OAHI 19.3 ± 18.8/h. BMI was higher (p = 0.0145) in females (32.9 ± 7.7) than in males (28.6 ± 5.3). This was also true for hip circumference (118 ± 15 vs 107 ± 10, p = 0.0006), while the neck circumference was higher (p < 0.0001) in males (41 ± 4 vs 37 ± 4).

The following parameters could predict the logOAHI (r2-adjusted = 0.51): sex (p < 0.0001), BMI (p = 0.0116), neck-depth/mandibular-length (p = 0.0002), mandibular-width angle (p = 0.0118), neck-depth euclidean distance/surface distance (E/S) (p = 0.0001) and the interaction terms between sex and neck-depth/mandibular-length (p = 0.0034), sex and neck-depth E/S (p = 0.0276) and BMI and neck-depth E/S (p = 0.0118).

The interaction between sex and neck-depth/mandibular-length showed a steeper linear course in females. This is also true for the interaction term BMI with neck-depth E/S in patients with a higher BMI. With a same neck-depth ratio, the OAHI is larger in men.

Conclusion

Measurements involving the width of the face and addressing the soft tissue in the upper neck were found to have a significant relation with OSA severity. We found remarkable differences between non-obese/obese subjects and between males and females.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium

    Ellen Collier, Nasser Nadjmi, Johan Verbraecken & Elke Van de Casteele

  2. Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Antwerp, Belgium

    Ellen Collier, Nasser Nadjmi & Elke Van de Casteele

  3. ZMACK/Associatie MKA, AZ Monica, Antwerp, Belgium

    Ellen Collier, Nasser Nadjmi & Elke Van de Casteele

  4. All for Research vzw, Antwerp, Belgium

    Nasser Nadjmi & Elke Van de Casteele

  5. Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Antwerp, Belgium

    Johan Verbraecken

Authors
  1. Ellen Collier
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  2. Nasser Nadjmi
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  4. Elke Van de Casteele
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Correspondence to Ellen Collier.

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The authors declare that they have no conflict of interest.

The authors have no relevant financial or non-financial interests to disclose.

The authors have no competing interests to declare that are relevant to the content of this article.

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

The authors have no financial or proprietary interests in any material discussed in this article.

Ethical approval

Approval of the institutional ethics committee was obtained on 29/10/2018 (UZA 18/34/375, BRN: B300201837854) and all subjects gave their written informed consent.

This study has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Collier, E., Nadjmi, N., Verbraecken, J. et al. Anthropometric 3D evaluation of the face in patients with sleep related breathing disorders. Sleep Breath 27, 2209–2221 (2023). https://doi.org/10.1007/s11325-023-02827-y

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  • DOI: https://doi.org/10.1007/s11325-023-02827-y

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