Airway changes in obstructive sleep apnoea patients associated with a supine versus an upright position examined using cone beam computed tomography

J Laryngol Otol. 2014 Sep;128(9):824-30. doi: 10.1017/S0022215114001686. Epub 2014 Aug 27.

Abstract

Objective: This study aimed to describe total volume and cross-sectional area measurement changes in obstructive sleep apnoea patients associated with a supine versus an upright position.

Method: A retrospective chart review of patients who underwent cone beam computed tomography in upright and supine positions was performed, and the images were analysed.

Results: Five obstructive sleep apnoea patients (all male) underwent both upright and supine cone beam computed tomography imaging. Mean age was 35.0 ± 9.3 years, mean body mass index was 28.1 ± 2.7 kg/m2 and mean apnoea-hypopnoea index was 39.3 ± 23.0 per hour. The airway was smaller when patients were in a supine compared with an upright position, as reflected by decreases in the following airway measurements: total volume; posterior nasal spine, uvula tip, retrolingual and tongue base (not significant) cross-sectional areas; and site of the minimum cross-sectional area (of the overall airway). Total airway volume decreased by 32.6 per cent and cross-sectional area measurements decreased between 32.3 and 75.9 per cent when patients were in a supine position.

Conclusion: In this case series, the airway of obstructive sleep apnoea patients was significantly smaller when patients were in a supine compared with an upright position.

MeSH terms

  • Adult
  • Cone-Beam Computed Tomography / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Posture / physiology*
  • Retrospective Studies
  • Sleep Apnea, Obstructive / physiopathology*
  • Supine Position
  • Trachea / physiology