Craniofacial Morphology in Obstructive Sleep Apnea

In Brief Obstructive sleep apnea (OSA) is a common disorder characterized by snoring, repetitive upper airway collapse during sleep, oxygen desaturation, and sleep fragmentation. The occurrence of OSA is the result of anatomic and functional abnormalities of the upper airway. Craniofacial bony restriction, enlargement of upper airway soft tissue structures, and central obesity are known anatomic risk factors for OSA. Although obesity is generally considered the major risk factor for OSA, craniofacial morphology is increasingly recognized as a key interacting factor in OSA pathogenesis. The use of cephalometry and other novel craniofacial and upper airway imaging modalities have provided us with insights into the significance of craniofacial morphology in OSA. Mandibular, maxillary, cranial base, hyoid and head position characteristics, in addition to the size of the upper airway and surrounding soft tissues, have been described extensively in the OSA literature. The influences of growth, gender, and ethnicity on craniofacial morphology are also gaining recognition. It is becoming clear that these craniofacial characteristics are not only important in the etiology of OSA, but they also have potentially important implications for the current and future approaches to the treatment and prevention of this condition. Craniofacial morphology is increasingly recognized as an important risk factor in obstructive sleep apnea pathogenesis. Awareness of these craniofacial characteristics would aid in the clinical identification of these important risk factors in patients and appreciation of their potentially etiologic role might have implications for the treatment of this condition.