Sleep-disordered breathing, pharyngeal size and soft tissue anatomy in children

R. F. Fregosi, S. F. Quan, K. L. Kaemingk, W. J. Morgan, J. L. Goodwin, R. Cabrera, A. Gmitro

Research output: Contribution to journalArticle

84 Scopus citations

Abstract

We tested the hypothesis that pharyngeal geometry and soft tissue dimensions correlate with the severity of sleep-disordered breathing. Magnetic resonance images of the pharynx were obtained in 18 awake children, 7-12 yr of age, with obstructive apnea-hypopnea index (OAHI) values ranging from 1.81 to 24.2 events/h. Subjects were divided into low-OAHI (n = 9) and high-OAHI (n = 9) groups [2.8 ± 0.7 and 13.5 ± 4.9 (SD) P < 0.001]. The OAHI correlated positively with the size of the tonsils (r2 = 0.42, P = 0.024) and soft palate (r2 = 0.33, P = 0.049) and inversely with the volume of the oropharyx (r2 = 0.42, P = 0.038). The narrowest point in the pharyngeal airway was smaller in the high- compared with the low-OAHI group (4.4 ± 1.2 vs. 6.0 ± 1.3 mm; P = 0.024), and this point was in the retropalatal airway in all but two subjects. The airway cross-sectional area (CSA)-airway length relation showed that the high-OAHI group had a narrower retropapatal airway than the low-OAHI group, particularly in the retropalatal region where the soft palate, adenoids, and tonsils overlap (P = 0.001). The "retropalatal air space," which we defined as the ratio of the retropalatal airway CSA to the CSA of the soft palate, correlated inversely with the OAHI (r2 = 0.49, P = 0.001). We conclude that 7- to 12-yr-old children with a narrow retropalatal air space have significantly more apneas and hypopneas during sleep compared with children with relatively unobstructed retropalatal airways.

Original languageEnglish (US)
Pages (from-to)2030-2038
Number of pages9
JournalJournal of Applied Physiology
Volume95
Issue number5
DOIs
StatePublished - Nov 2003

Keywords

  • Apnea
  • Hypopnea
  • Magnetic resonance imaging
  • Obstructive apnea hypopnea index
  • Upper airway

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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