Impact of elevated BMI on pharyngeal airway dimensions and sleep quality in patients with normal maxillomandibular skeletal relationships.

BACKGROUND

The dimensions of the pharyngeal air space (PAS) are influenced by certain factors, including different facial morphological patterns and/or accumulation of fat on the pharyngeal walls, potentially affecting sleep quality and predisposing individuals to obstructive sleep apnea-hypopnea syndrome (OSAHS).

METHODS

The PAS dimensions and the area of greatest pharyngeal constriction in individuals with an angle class I maxillomandibular relationship and a BMI > 25 kg/m², correlating these with cervical and abdominal measures and sleep quality data. Cone-beam computed tomography (CBCT) scans of 50 participants (25 of each sex, aged 18 years or older, Class I occlusion, BMI > 25 kg/m²) were analyzed via Dolphin Imaging 11.95 software to determine the PAS area and volume. Participants also had their waist and neck circumferences measured, in addition to sleep quality assessment through the application of the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS) and the Berlin Questionnaire (BQ).

RESULTS

Significant correlations were found between oropharyngeal dimensions, BMI, and abdominal circumference. Higher BMI was associated with decreased oropharyngeal volume. Total PAS, oropharynx, hypopharynx, and maximum pharyngeal constriction values were significantly linked to excessive daytime sleepiness. A reduced total PAS was also associated with increased OSAHS risk. No significant differences were found between sexes in sleep quality, excessive daytime sleepiness, or OSAHS risk.

CONCLUSION

Increased BMI and abdominal circumference are associated with narrower oropharyngeal dimensions and poorer sleep quality, contributing to higher daytime sleepiness and OSAHS risk, regardless of sex.