Evidence map›Paper›PMID 30040909›Full record

ArticleAmerican journal of respiratory and critical care medicine2018

Dynamic Upper Airway Imaging during Wakefulness in Obese Subjects with and without Sleep Apnea.

Yuan Feng, Brendan T Keenan, Stephen Wang, Sarah Leinwand, Andrew Wiemken, Allan I Pack, Richard J Schwab

Abstract read
In one paragraph

Article in American journal of respiratory and critical care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% 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

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.

  1. Dynamic sleep MRI in obstructive sleep apnea: a systematic review and meta-analysis.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 · 2022
    Pooled it
  2. Airway Anatomy and Surgical Management in Obstructive Sleep Apnea.Clinical and experimental otorhinolaryngology · 2026
    Review
  3. Review
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  6. A nomogram for predicting tongue collapse in DISE based on UACT findings in OSA patients.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 · 2025
    Article
  7. Analysis of Possible Predictors of Moderate and Severe Obstructive Sleep Apnea in Obese Patients.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Yuan Feng1 Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China; and.
Brendan T Keenan2 Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania.
Stephen Wang2 Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania.
Sarah Leinwand2 Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania.
Andrew Wiemken2 Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania.
Allan I Pack2 Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania.
Richard J Schwab2 Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania.
University of Pennsylvania · USNanfang Hospital · CN

Funding

Understanding the relationship between obesity and tongue fat in humans and ratsP01HL094307 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI PACK, ALLAN I · 2009 to 2020
$23.7M
Obesity & OSA: Understanding the Importance of Tongue Fat and Metabolic FunctionR01HL089447 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI SCHWAB, RICHARD J. · 2008 to 2011
$2.4M
NHLBI NIH HHS P01 HL094307NHLBI NIH HHS R01 HL089447
6 · The paper itself

Abstract

rationaleObesity is a major risk factor for obstructive sleep apnea. Although greater dimensional changes in the upper airway during wake respiration have been noted in patients with apnea compared with control subjects, whether these differences remain in the presence of obesity is unknown.

objectivesTo evaluate upper airway anatomic characteristics and airway compliance (distensibility) in obese subjects with obstructive sleep apnea compared with obese control subjects.

methodsDynamic magnetic resonance imaging was performed in 157 obese subjects with apnea and 46 obese control subjects during wakefulness in the midsagittal and three axial upper airway regions (retropalatal, retroglossal, epiglottal). Differences in measurements between subjects with apnea and control subjects, and correlations with apnea-hypopnea index among subjects with apnea, were examined. MEASUREMENTS AND MAIN

resultsMeasurements included airway areas and linear dimensions. Subject-specific coefficients of variation were calculated to examine variability in airway size. Controlling for covariates, the retropalatal area during respiration was significantly smaller in subjects with apnea than control subjects, based on the average (P = 0.003), maximum (P = 0.004), and minimum (P = 0.001) airway area. Airway narrowing was observed in anteroposterior and lateral dimensions (adjusted P < 0.05). Results were similar in an age, sex, and body mass index-matched subsample. There were significant correlations between apnea-hypopnea index and dynamic measures of airway caliber in the retropalatal and retroglossal regions among subjects with apnea.

conclusionsUpper airway caliber during respiration was significantly narrower in obese subjects with apnea than obese control subjects in the retropalatal region. These findings provide further evidence that retropalatal airway narrowing plays an important role in the pathogenesis of obstructive sleep apnea in obese subjects.

Indexed as

WakefulnessAdultCase-Control StudiesFemaleHumansLarynxMagnetic Resonance ImagingMaleMiddle AgedObesityPharynxRespiratory SystemSleep Apnea, ObstructiveTracheadynamic upper airwaymagnetic resonance imagingobesityobstructive sleep apnearespiration

Identifiers

PMID30040909
PMCPMC6290952
OpenAlexW2884888816

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.