Risk factors for sleep-disordered breathing: the role of craniofacial structure

Abstract

Objective. To evaluate possible differences in craniofacial structure between overweight patients and normal-weight patients with mild sleep-disordered breathing (SDB). Material and methods. Subjects were recruited from patients referred to Kuopio University Hospital due to suspicion of SDB. They were divided into two groups based on their body mass index (BMI). The overweight group (BMI > 27 kg/m²) consisted of 58 males and 19 females and the normal weight group (BMI ≤ 27 kg/m²) of 33 males and 15 females. The mean age of the subjects was 51.4 years. All subjects underwent an overnight cardiorespiratory recording. The mean apnea–hypopnea index (AHI) was 9.3 events/h for the entire study population. Occlusion and craniofacial morphology were examined by an experienced orthodontist. Results. Significant differences in craniofacial morphology and occlusion were found between the groups: the craniofacial profile in normal-weight patients was more convex (P < 0.000) and the mandible more retrusive (P = 0.004) than in overweight subjects. In addition, distal molar occlusion (P = 0.005) was more prevalent in normal-weight subjects, and their overjet and overbite were increased as compared to overweight patients (P = 0.009 and 0.006, respectively). Similarly, cross bite was detected significantly more often in normal-weight subjects (P = 0.052). Conclusions. These results reveal that deviations in craniofacial morphology and occlusion are more frequent in normal subjects than in overweight subjects with mild SDB; this may well have implications in the pathophysiology of SDB.

Key Words::

• Craniofacial morphology
• obesity
• occlusion
• sleep-disordered breathing

Acknowledgements

We express our special thanks to Riitta Myllykangas, a dental hygienist, and Taina Poutiainen, a specially trained nurse, for their contributions throughout the study. This study was supported by grants from the Hospital District of Northern Savo, Kuopio University Hospital, the Finnish Cultural Foundation, the Academy of Finland, the Pulmonary Association Heli, and the Finnish Dental Society Apollonia/Division of Orthodontics. The funding sources had no role in the study design or in the collection, analysis, or interpretation of the data.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.