Soft palate length and upper airway relationship in OSA and non-OSA subjects

Keywords:  Soft palate length, Oropharyngeal airway, Obstructive sleep apnea, Computerized tomography, orofacial pain, upper airway and dental sleep medicine

Obstructive sleep apnea (OSA) is a condition that can severely impacts one’s health and lifestyle.  Dr. Stan Farrell, a member of the American Academy of Dental Sleep Medicine and board certified with the American Board of Orofacial Pain, has extensive training in treating sleep apnea.  He continues to use the most successful techniques and equipment in treating sleep apnea at his office in Scottsdale, AZ.  He is passionate about increasing his knowledge and understanding of OSA syndrome.  The abstract article below highlights some of the latest advances in identifying potentially at risk patients. The report discovered that soft palate length was significantly larger in OSA patients than non-OSA patients, which could conceivably serve as an identifier for patients more susceptible to OSA.  If you think you might be suffering from obstructive sleep apnea, call Dr. Farrell at 480-945-3629 to set your consultation and visit AZ TMJ at www.headpaininstitute.com

Yuko Shigeta, Takumi Ogawa, Ikawa Tomoko, Glenn T. Clark, and Reyes Enciso

Background:  The narrowest area of the airway between the posterior nasal opening and the epiglottis is usually located in the retro palatal area. Many consider this the most likely site of airway obstruction during an obstructive sleep apnea (OSA) event. The aim of this study was to investigate the differences in soft palate and airway length between OSA and non-OSA patients.

Methods:  In this study, we analyzed the ratio of the soft palate and the upper airway length in 45 consecutive patients. Twenty-five had an Apnea–Hypoapnea Index of more than five events per hour and were classified in the OSA group (male, 19; female, 6). These patients were compared with 20 normal controls (male, 12; female, 8). Controls who complained of snoring did have sleep studies (n=5). The other fifteen controls were clinically asymptomatic and did not have sleep studies. Medical computed tomography scans were taken to determine the length of the upper airway and the soft palate length measured in the midsagittal image.

Results:  Soft palate length was significantly larger in OSA patients compared to controls (p=0.009), and in men compared to women (p=0.002). However, there were no differences in airway length. The soft palate length, as a percent of oropharyngeal airway length, was significantly larger in OSA patients compared to controls (p=<0.0001) and in men compared to women (p=0.02). Soft palate length increases significantly with age by 0.3 mm per year in males (after adjustment for body mass index (BMI) and OSA). Soft palate length as a percent of airway length is larger in OSA patients and increases significantly with BMI in males only after adjusting for age.

Conclusion:  In this study, OSA patients had a longer soft palate in proportion to their oropharyngeal airway compared to controls as well as men compared to women. This proportion could be used for identifying patients at risk for OSA in combination with age. (Sleep Breath. 2010 December; 14(4): 353–358)