Morphostatic correlates and sleep apneas

CUGY Didier ; LAVAUD Eric ; PATY, Jacques

The clinical observation of patients suffering from SAS reveals morphological similarities between the patients. Having a broad neck with a circumference higher than 42 cm has already been identified like a clinical factor (1). Others Predicting Indicators are described (2,3). Moreover, these patients also present morphostatic similarities frequently characterized by a cervical ciphose and a rolling up of the shoulders

This morphostatic aspect can be easily quantified (the subject at rest, his back positioned against a vertical plane) from the measurement of the distances separating the inion and the acromion to the vertical and the measurement of the distance hand-vertical (the subject being hands up).

Material and Methods : Measurements of the distances inion vertical (DIV), acromion vertical (DAV), hands vertical (DMV) were linked to the results of 214 polysomnographies. The data reported to the indices of apnea, hypopneas, desaturations, saturometry by stage of sleep were analyzed by regression and analysis of variance.

Results : significant regression between DIV and IAH (p=2x10-4)) ; DAV and SpO2 (Stage one and two p=7,8x10-3 ; REM p=1,1x10-3) ; DMV and desaturation index (Stage one and two p=1,91x10-2, REM p=7,6x10-3) was revealed.

Conclusion : Morphostatic relations between measurement of the distances Inion vertical, Acromion vertical, Hands Vertical and ventilatory parameters of sleep enables to propose the use of these parameters to suspect ventilatory anomalies during sleep. In addition, the use of techniques of rehabilitation aiming at correcting these parameters in the caring of sleep respiratory pathologies can be considered.

References :
1. Dixon J.B. & al. Predicting Sleep Apnoea and Excessive Day Sleepiness in Severely Obese : Indicators for polysomnography. Chest 2003 ;123 ;1134-1141
2. Joseph B & al, Physical findings and the risk of obstructive sleep apnea. Am J Resp Crit Care Med Vol 162 :.pp 740-748, 2000
3. Skomro R.P. and Kryger H. Clinical Presentations of Obstructive Sleep Apnoea Syndrome. Cardiovascular Diseases, vol 41 N° 5 (March/April), 1999 : pp 331-340