Abstract
The prevalence of obstructive sleep apnoea (OSA) increases with age, yet the risk factors for OSA in older people remain poorly understood.
This study aimed to define the age-related changes in upper airway morphology in carefully matched groups of healthy older (>60 years, n=11) and younger (<40 years, n=14) males, using direct (magnetic resonance imaging (MRI)) and indirect (acoustic reflection) imaging.
The median (interquartile range) combined retropalatal and retroglossal pharyngeal length was greater in older than in younger males (older 8.8 (7.8–9.0) cm, younger 7.8 (7.0–8.3) cm; p=0.03), as was the soft palate cross-sectional area (older 43.1 (36.0–48.8) cm2, younger 35.3 (30.5–40.5) cm2; p=0.03), parapharyngeal fat pad diameter (older 1.7 (1.4–2.2) cm, younger 1.2 (1.0–1.8) cm; p=0.03) and cross-sectional area of the fat pads (older 13.8 (9.1–17.1) cm2; younger 7.4 (5.9–13.0) cm2; p=0.02) as measured by MRI. Using acoustic reflection, pharyngeal calibre (older 4.8 (3.8–6.6) cm2, younger 3.4 (2.8–4.6) cm2; p=0.03), pharyngeal volume (older 35.1 (30.9–55.4) cm3, younger 27.2 (22.7–44.2) cm3; p=0.04) and glottis area (older 2.7 (2.1–3.9) cm2, younger 1.3 (1.1–1.9) cm2; p=0.003) were also larger in older participants compared with younger participants. There was no difference in craniofacial measures between groups, including volumetric data and hyoid bone position.
The larger pharyngeal calibre observed in older males may be compensating for an age-related enlargement in pharyngeal soft tissue that predisposes to OSA.
Abstract
Pharyngeal factors predisposing to sleep apnoea increase with age; a larger calibre protected against airway collapse http://ow.ly/v746x
Footnotes
Support statement: This project was supported by a grant from the National Heart and Lung Institute Foundation, Imperial College London and by the NIHR Respiratory and Cardiovascular Biomedical Research Units at the Royal Brompton and Harefield NHS Foundation Trust.
Conflict of interest: Disclosures can be found alongside the online version of this article at erj.ersjournals.com
- Received October 10, 2013.
- Accepted March 23, 2014.
- ©ERS 2014