Head posture and snoring ?

[Guest guest]

Perhaps something out of these might be helpful ?

sharron fuchs dc

*****AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS*****

(REFERENCE 1 OF 4)

96216344

Pracharktam N S Hans MG Broadbent BH Redline S Rosenberg C

Strohl KP

Cephalometric assessment in obstructive sleep apnea.

In: Am J Orthod Dentofacial Orthop (1996 Apr) 109(4):410-9

ISSN: 0889-5406

It is reported that some specific craniofacial characteristics are

associated with obstructive sleep apnea syndrome (OSAS). To test this

finding, the present study developed and assessed the feasibility of

a craniofacial index score (CIS) in differentiating patients with

OSAS from habitual snorers. Anthropometric measurements and lateral

head radiographs were obtained on 24 male and 4 female patients with

OSAS who had physician-diagnosed OSAS (respiratory disturbance index

(RDI) >20), and 25 male and 5 female habitual snorers (RDI <20).

Thirteen cephalometric and four anthropometric measure- ments were

used in a discriminant model to construct the CIS. The model was able

to correctly classify 82.1% of the OSAS group and 86.7% of the

snoring group. In addition, variables that were related to the soft

tissues, hyoid bone to mandibular plane, Body Mass Index, and soft

palate length had the highest predictive value. These findings

indicate that a CIS constructed from cephalometric and anthropometric

measurements can be used to identify subjects with and without OSAS.

Institutional address:

Department of Orthodontics School of Dentistry

Case Western Reserve University

Ohio

USA.

*****CRANIO*****

(REFERENCE 2 OF 4)

98247637

Makofsky HW

Snoring and obstructive sleep apnea: does head posture play a role?

In: Cranio (1997 Jan) 15(1):68-73

ISSN: 0886-9634

The aim of this article is to present scientific and clinical

evidence to support the role of proper head and neck posture in the

management of snoring and obstructive sleep apnea. Obstruction of the

upper-airway during sleep is a serious medical condition often

associated with severe daytime somnolence, morning headache, and a

host of cardiopulmonary complications, including but not limited to

systemic and pulmonary hypertension, nocturnal cardiac dysrhythmias,

myocardial infarction, and stroke. Though anti-snoring pillows are

occasionally mentioned in the literature, the role of proper head-

neck support during sleep has been largely neglected. In this article

the effect of head-neck position on upper-airway obstruction during

sleep is discussed from the perspective of both causation and

treatment. Based on the evidence presented by the author, it is

recommended that the use of cervical-support pillows be considered as

an adjunctive treatment modality in patients suffering from snoring

and obstructive sleep apnea.

Institutional address:

State University of New York at Stony Brook

USA.

*****JOURNAL OF OTOLARYNGOLOGY*****

(REFERENCE 3 OF 4)

Mlynarek A Tewfik MA Hagr A Manoukian JJ Schloss MD Tewfik TL

Choi-Rosen J

Lateral neck radiography versus direct video rhinoscopy in assessing

adenoid size.

In: J Otolaryngol (2004 Dec) 33(6):360-5

ISSN: 0381-6605

OBJECTIVE: To evaluate the usefulness of adynamic lateral neck

radiographs and dynamic video rhinoscopy in assessing adenoid size

and the relationship of these methods to associated symptoms and thus

the severity of the disease. METHODS: Children with suspected adenoid

hypertrophy underwent standard lateral neck soft tissue radiographs:

the percentage of airway occlusion, adenoid to nasopharynx (AN)

ratio, airway to soft palate ratio, and adenoid thickness were

assessed by a radiologist. The percentage of airway closure was

assessed by direct fibre-optic rhinoscopy in an ear, nose, and throat

clinic. Associated clinical symptoms were assessed by parents using a

standardized questionnaire, evaluating the severity of symptoms

(snoring, sleep apnea, mouth breathing, and otitis media) to give a

total symptom score out of 16. RESULTS: Nonparametric statistical

analysis using Spearman's correlation coefficients was performed on

32 patients. There was a weak correlation, which approaches

significance, between the percentage of airway occlusion assessed by

fibre-optic rhinoscopy and the total symptom score (r = .344, p =

..054). However, this correlation becomes significant when the

frequency of otitis media is omitted (r = .367, p = .039). There was

also a significant correlation between airway occlusion assessed by

rhinoscopy and the percentage of airway occlusion as determined by

lateral neck radiography (r = .431, p = .014). There was no

correlation between any of the measurements taken by lateral soft

tissue neck radiography and total symptom score. CONCLUSION: Dynamic

video rhinoscopy is more accurate at assessing adenoid hypertrophy,

and the percentage of airway occlusion, as estimated by video

rhinoscopy, is better correlated to the severity of symptoms than are

values obtained by lateral neck radiography.

Institutional address:

Department of Otolaryngology-Head and Neck Surgery

Montreal Children's Hospital

McGill University

Montreal

Quebec.

*****SLEEP RES ONLINE*****

(REFERENCE 4 OF 4)

21276777

Kushida CA Rao S Guilleminault C Giraudo S Hsieh J Hyde P

Dement WC

Cervical positional effects on snoring and apneas.

In: Sleep Res Online (1999) 2(1):7-10

ISSN: 1096-214X

We examined the effects of cervical position on the Obstructive Sleep

Apnea Syndrome (OSAS) through the use of a custom-designed cervical

pillow which promoted neck extension. Twelve subjects with OSAS were

recruited from a tertiary sleep disorder clinic population. Of the

twelve subjects, three had mild cases of OSAS, four had moderate

cases, and the remaining five had severe cases. The subjects used

their usual pillows during two consecutive recorded baseline nights

in our laboratory. The subjects then used the cervical pillow for

five days at home, and returned for two consecutive recorded nights

at our laboratory while using the cervical pillow. During the nights

in our laboratory, the subjects completed questionnaires, were

videotaped to record head and body position, and had their breathing

parameters recorded during sleep. Subjects with mild OSAS cases had a

non-significant improvement in the severity of their snoring and a

significant improvement in their respiratory disturbance index with

the cervical pillow, while subjects with moderate OSAS cases showed

no improvement in these parameters. Subjects with severe OSAS cases

showed slight improvement in some measures of their abnormal

respiratory events during the experimental period.

Institutional address:

Stanford University Sleep Disorders Clinic and Research Center

Stanford

California

94305

USA. clete@...

From: [mailto: ] On Behalf Of bingonis@...Sent: Wednesday, February 22, 2006 11:09 AMDr. ph Medlin D.C.; Subject: Re: IME Question

Has anyone come across any studies that have linked head forward posture to snoring?