Evidence map›Paper›PMID 25197805›Full record

ArticleSleep2014

Upper airway collapsibility is associated with obesity and hyoid position.

Pedro R Genta, Fabiola Schorr, Danny J Eckert, Eloisa Gebrim, Fabiane Kayamori, Henrique T Moriya, Atul Malhotra, Geraldo Lorenzi-Filho

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Sleep, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
89citing papers in PubMed, 4 pooled it
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

89 citing papers in PubMed, 4 syntheses or guidelines pooled it, 196 citations in OpenAlex.

  1. Pooled it
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  7. Uvulopalatopharyngoplasty with and without modified thyrohyoid suspension for obstructive sleep apnea treatment: a randomized clinical trial.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2023
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  15. The upper airway in obstructive sleep apnoea: state of the art.European respiratory review : an official journal of the European Respiratory Society · 2026
    Review
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29 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 3 countries.

Pedro R GentaPulmonary Division, Heart Institute (InCor), Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil and Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard University, Boston, MA.
Fabiola SchorrPulmonary Division, Heart Institute (InCor), Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
Danny J EckertNeuroscience Research Australia (NeuRA) and the School of Medical Sciences, University of New South Wales, Sydney, Australia.
Eloisa GebrimRadiology Institute (InRad), Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
Fabiane KayamoriPulmonary Division, Heart Institute (InCor), Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
Henrique T MoriyaBiomedical Engineering Laboratory, University of São Paulo, São Paulo, Brazil.
Atul MalhotraDivision of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard University, Boston, MA and Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, CA.
Geraldo Lorenzi-FilhoPulmonary Division, Heart Institute (InCor), Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRBrigham and Women's Hospital · USUniversidade de São Paulo · BRUniversity of California, San Diego · USUNSW Sydney · AU

Funding

Harvard Clinical and Translational Science Center (UL1)UL1TR000170 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2012 to 2013
$31.4M
Single Motor Unit Genioglossus Recordings to Understand Sleep Apnea PathogenesisR01HL085188 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2008 to 2018
$3.5M
NCATS NIH HHS 8UL1TR000170-05NHLBI NIH HHS R01 HL085188
6 · The paper itself

Abstract

STUDY

objectivesUpper airway anatomy plays a major role in obstructive sleep apnea (OSA) pathogenesis. An inferiorly displaced hyoid as measured by the mandibular plane to hyoid distance (MPH) has been consistently associated with OSA. The hyoid is also a common landmark for pharyngeal length, upper airway volume, and tongue base. Tongue dimensions, pharyngeal length, and obesity are associated with OSA severity, although the link between these anatomical variables and pharyngeal collapsibility is less well known. We hypothesized that obesity as measured by body mass index (BMI), neck and waist circumferences, and variables associated with hyoid position (pharyngeal length, upper airway volume, and tongue dimensions) would be associated with passive pharyngeal critical closing pressure (Pcrit).

designCross-sectional.

settingAcademic hospital. PATIENTS: 34 Japanese-Brazilian males age 21 to 70 y.

interventionsN/A. MEASUREMENTS AND

resultsWe performed computed tomography scans of the upper airway, overnight polysomnography, and Pcrit measurements in all subjects. On average, subjects were overweight (BMI = 28 ± 4 kg/m(2)) and OSA was moderately severe (apnea-hypopnea index = 29 [13-51], range 1-90 events/h). Factor analysis identified two factors among the studied variables: obesity (extracted from BMI, neck and waist circumferences) and hyoid position (MPH, pharyngeal length, tongue length, tongue volume, and upper airway volume). Both obesity and hyoid position correlated with Pcrit (r = 0.470 and 0.630, respectively) (P < 0.01). In addition, tongue volume, tongue length, pharyngeal length, and MPH correlated with waist and neck circumferences (P < 0.05).

conclusionsPharyngeal critical closing pressure is associated with obesity and hyoid position. Tongue dimensions, pharyngeal length, and the mandibular plane to hyoid distance are associated with obesity variables. These findings provide novel insight into the potential factors mediating upper airway collapse in obstructive sleep apnea.

Indexed as

AdultAgedAsian PeopleBody Mass IndexBrazilCross-Sectional StudiesHumansHyoid BoneJapanMaleMiddle AgedNeckObesityPharynxPolysomnographySleep Apnea, Obstructivecomputed tomographylungobstructive sleep apneapathophysiologypharynx

Identifiers

PMID25197805
PMCPMC4173923
OpenAlexW1983589524

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.