Evaluating BMI, Upper Airway Dimensions, and Hyoid Bone Position and their Correlation in Non-OSA Snoring Adults: the First CBCT Study.

Background: Precise knowledge about the characteristics of individuals who snore but do not have obstructive sleep apnea (OSA) is essential yet remains limited in the literature.

Purpose: This study aimed to evaluate BMI (body mass index), upper airway dimensions, hyoid bone position, and their relationship in non-OSA snoring adults using cone-beam computed tomography.

Materials and method: In this retrospective cross-sectional study, cone beam computed tomography (CBCT) records of 100 patients were analyzed. Patients were snoring non-OSA individuals, diagnosed through a thorough examination and negative polysomnography results. CBCT scans were executed in the standard position as per the specified protocol of the Sleep Center. Upper airway was divided into four parts (nasopharynx, velopharynx, oropharynx, and hypopharynx), and anteroposterior (AP) and transverse (T) dimensions within the minimal cross-sectional area of each respective region were evaluated. BMI, upper airway dimension, and hyoid bone were analyzed using Pearson and Spearman's correlation tests.

Results:  The retrognathion-hyoid-4th cervical vertebra (RHV) angle representative of the hyoid position was significantly greater in females (p Value=0.000). It also statistically decreased significantly in snorers aged 36-50 and 51-65, p= 0.006 and 0.012, respectively. Snorers had above-average BMI in all age groups and both genders. The AP-hypopharynx significantly correlated with BMI (p= 0.022).

Conclusion:  The hyoid position was gender-dependent, with a superior position in females. It was also age-dependent, with a more inferior position in snorers aged 36-65 compared to younger ages (20-35). The AP-velopharynx is a constriction region in the airway of snorers. Snorers were overweight in all age groups and both genders. BMI had a significant correlation with the AP-hypopharynx.