Efficacy of upper airway ultrasonography in detecting obstructive sleep apnea in the general population

Submental upper airway ultrasonography can be used to assess the risk of moderate to severe obstructive sleep apnea (OSA). This study investigates whether the model based on upper airway ultrasonography can detect potential OSA in the general population.

We recruited 1101 individuals attending health check-up at Health Management Center. They underwent standardized ultrasound scans that were performed with a projected laser beam to align each participant's head and the ultrasound transducer. The observability of the upper airway and observable width of the airway were evaluated using AmCAD-UO software. OSA risk was assessed on the basis of the ultrasound findings.

Among 323 high-risk and 277 medium-risk participants, 97 and 8, respectively, were referred to sleep medicine clinics and received overnight polysomnography. The positive predictive values (PPVs) derived for participants with mild, moderate and severe OSA were 94.8%, 87.6%, and 72.2%, respectively. Subgroup analysis revealed that among the participants with OSA, 48 had obesity and were significantly younger than those without obesity (n = 44). Although the average supine AHI and average oxygen desaturation index derived for the obesity subgroup were higher than those derived for the non-obesity subgroup, the average AHI or average minimum oxygen saturation levels did not differ between the subgroups.

Ultrasound imaging of the upper airway could be used to estimate the risk of moderate to severe OSA in individuals attending health check-up. It also enables detection of subclinical OSA in individuals with normal body mass index and could be useful in health management centers for screening potential OSA.