Tongue scalloping as a sign of obstructive sleep apnea syndrome: Clinical and polysomnographic insights.

Abstract

Background: Polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea syndrome (OSAS), but identifying clinical markers can aid early detection. Tongue scalloping (TS) indicates upper airway obstruction, but its diagnostic significance in OSAS requires further exploration. The present study was to assess the prevalence of TS in individuals with obesity and high-risk features of sleep-disordered breathing and to evaluate its correlation with polysomnographic parameters compared to snoring and daytime somnolence.

Methods: This observational cross-sectional study included 1261 participants, of whom 250 were diagnosed with OSAS via PSG. Demographic, clinical, and polysomnographic data were analyzed to compare OSAS and non-OSAS groups, as well as OSAS patients with and without TS. Diagnostic accuracy measures, including sensitivity, specificity, and predictive values, were calculated for TS, snoring, and daytime somnolence.

Results: OSAS patients were significantly older and had a higher prevalence of snoring, smoking, and daytime somnolence. TS was observed in 39.6% of OSAS patients compared to 20.5% of non-OSA participants (P < 0.001). TS exhibited moderate specificity (79.5%) and a high negative predictive value (84.2%) for OSAS diagnosis. It showed the highest specificity for nocturnal desaturation (84%) and had a high positive predictive value (90%). Logistic regression identified smoking, TS, snoring, daytime somnolence, higher neck circumference, body mass index, and waist-to-height ratio as independent OSAS predictors.

Conclusion: TS is a valuable clinical marker for OSAS, particularly in high-risk individuals. Combined with established clinical features, it can enhance non-invasive screening and aid in early detection and diagnosis.