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Head posture in obstructive sleep apnoea

B Solow1, J Ovesen, P W Nielsen

  • 1Orthodontic Department, School of Dentistry, University of Copenhagen, Denmark.

European Journal of Orthodontics
|April 1, 1993
PubMed
Summary
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Severe obstructive sleep apnea (OSA) is linked to increased cranio-cervical angulation. This head posture may be an adaptation to maintain an open airway, supporting the airway obstruction hypothesis.

Area of Science:

  • Orthodontics
  • Sleep Medicine
  • Craniofacial Anatomy

Background:

  • Upper airway obstruction can influence facial development in growing individuals.
  • The soft-tissue stretching hypothesis suggests increased cranio-cervical angulation due to airway obstruction.
  • Limited research exists on cranio-cervical posture in adult obstructive sleep apnea (OSA) patients.

Purpose of the Study:

  • To investigate the effect of airway obstruction on cranio-cervical posture in adult OSA patients.
  • To evaluate the relationship between OSA severity and cranio-cervical angulation.

Main Methods:

  • Lateral cephalometric radiographs in natural head position were analyzed.
  • 50 adult male patients with diagnosed severe OSA were included.
  • Cranio-cervical angle (NSL/OPT) was measured and compared to control groups.

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Main Results:

  • OSA patients exhibited significantly larger average cranio-cervical angles (mean 104.1°) compared to controls.
  • The observed angle exceeded control group averages by 1-2 standard deviations (P < 0.001).
  • Apnea Index ranged from 21 to 98 episodes/hour (mean 54.6).

Conclusions:

  • Adults with severe OSA demonstrate increased cranio-cervical angulation.
  • This angulation may represent a physiological adaptation to maintain airway patency.
  • Findings support the hypothesis linking upper airway obstruction to altered cranio-cervical posture.