Avaliação cefalométrica da via aérea superior em mulheres com apneia obstrutiva do sono

Abstract

INTRODUCTION: Obstructive sleep apnea (OSA) is a respiratory disorder characterized by recurrent episodes of partial or complete collapse of the upper airway (UA) during sleep. OSA is more difficult to identify in women than in men. More specific characteristics such as primary snoring, excessive daytime sleepiness or respiratory pauses are not always reported by women. Because they present non-specific symptoms for OSA such as insomnia, depression, and fatigue, they are often treated for their complaints and are not always referred for polysomnography (PSG). On average, a woman takes 9.7 years from the first symptoms until she is diagnosed with OSA. Some morphological changes of the face and VAS observed in lateral cephalometric radiography (LCR) may contribute to an earlier diagnosis of OSA in women. OBJECTIVE: To compare craniofacial and UA dimensions changes in women with mild and moderate OSA using LCR. METHODS: 44 LCR of women aged 30 to 67 years were calibrated and measured in the Radiocef® program. 26 LCR were of women diagnosed by PSG with mild and moderate OSA (Group with OSA) and 18 LCR were of women without risk of having the disease (Group without OSA), diagnosed through the STOP-BANG questionnaire. Craniofacial measurements and VAS dimensions were performed. The sample was statistically evaluated through comparison, correlation and association of the measurements between groups. RESULTS: There was a statistically significant difference (p<0.05) between the groups with and without OSA, mainly for the increase of the UA vertical measurements and decrease of the posterior air space in the OSA group. Significant increase in the anterior facial high, opening of the mandibular plane, retrusion of the maxilla and of the mandible were also significant in this group. Increase of the facial convexity angle was a risk factor for the presence of OSA in women (OR = 1,541). CONCLUSION: LCR is an effective screening tool in the identification of craniofacial and UA characteristics in women with suspected OSA. Thus, it is an important method for the early recognition of mild and moderate OSA and for the referral of women to PSG