{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:06:57Z","timestamp":1788808017305,"version":"build-2803163510"},"reference-count":40,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Sleep Medicine"],"published-print":{"date-parts":[[2020,11]]},"DOI":"10.1016\/j.sleep.2020.09.008","type":"journal-article","created":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T11:45:38Z","timestamp":1599738338000},"page":"468-476","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":17,"special_numbering":"C","title":["Obstructive sleep Apnea's association with the cervical spine abnormalities, posture, and pain: a systematic review"],"prefix":"10.1016","volume":"75","author":[{"given":"Tri","family":"Pham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Kuang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin","family":"Leek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravindra","family":"Chandrashekhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3969-9221","authenticated-orcid":false,"given":"Thiru M.","family":"Annaswamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"9","key":"10.1016\/j.sleep.2020.09.008_bib1","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1093\/aje\/kws342","article-title":"Increased prevalence of sleep-disordered breathing in adults","volume":"177","author":"Peppard","year":"2013","journal-title":"Am J Epidemiol"},{"issue":"5","key":"10.1016\/j.sleep.2020.09.008_bib2","first-page":"246","article-title":"Burden of sleep apnea: rationale, design, and major findings of the Wisconsin Sleep Cohort study","volume":"108","author":"Young","year":"2009","journal-title":"WMJ"},{"issue":"8","key":"10.1016\/j.sleep.2020.09.008_bib3","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis","volume":"7","author":"Benjafield","year":"2019","journal-title":"Lancet Respir Med"},{"issue":"10","key":"10.1016\/j.sleep.2020.09.008_bib4","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1164\/rccm.200605-629PP","article-title":"Sleep apnea, alertness, and motor vehicle crashes","volume":"176","author":"George","year":"2007","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"10.1016\/j.sleep.2020.09.008_bib5","first-page":"143","article-title":"Cephalometric and demographic characteristics of obstructive sleep apnea: an evaluation with partial least squares analysis","volume":"67","author":"Lowe","year":"1997","journal-title":"Angle Orthod"},{"issue":"3","key":"10.1016\/j.sleep.2020.09.008_bib6","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1055\/s-0036-1584295","article-title":"Craniocervical posture in patients with obstructive sleep apnea","volume":"20","author":"Piccin","year":"2016","journal-title":"Int Arch Otorhinolaryngol"},{"issue":"6","key":"10.1016\/j.sleep.2020.09.008_bib7","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/j.ajodo.2016.05.011","article-title":"Relationship between head posture and the severity of obstructive sleep apnea","volume":"150","author":"S\u00f6k\u00fcc\u00fc","year":"2016","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"2","key":"10.1016\/j.sleep.2020.09.008_bib8","first-page":"139","article-title":"Obstructive sleep apnea (OSA): a cephalometric analysis of severe and non-severe OSA patients. Part I: multiple comparison of cephalometric variables","volume":"15","author":"Tangugsorn","year":"2000","journal-title":"Int J Adult Orthodon Orthognath Surg"},{"issue":"6","key":"10.1016\/j.sleep.2020.09.008_bib9","doi-asserted-by":"crossref","first-page":"20130060","DOI":"10.1259\/dmfr.20130060","article-title":"Cervical vertebral column morphology in patients with obstructive sleep apnoea assessed using lateral cephalograms and cone beam CT. A comparative study","volume":"42","author":"Sonnesen","year":"2013","journal-title":"Dentomaxillofac Radiol"},{"issue":"3","key":"10.1016\/j.sleep.2020.09.008_bib10","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1007\/s00586-013-3046-4","article-title":"Sleep apnea and cervical spine pathology","volume":"23","author":"Khan","year":"2014","journal-title":"Eur Spine J"},{"issue":"4","key":"10.1016\/j.sleep.2020.09.008_bib11","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1016\/j.ejcdt.2015.05.010","article-title":"Alteration in cervical spine mechanics in obstructive sleep apnea syndrome patients","volume":"64","author":"Saleh","year":"2015","journal-title":"Egyptian J Chest Dis Tuberculosis"},{"issue":"3","key":"10.1016\/j.sleep.2020.09.008_bib12","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1093\/ejo\/24.3.263","article-title":"Postural variation in oropharyngeal dimensions in subjects with sleep disordered breathing: a cephalometric study","volume":"24","author":"Battagel","year":"2002","journal-title":"Eur J Orthod"},{"issue":"1","key":"10.1016\/j.sleep.2020.09.008_bib13","first-page":"55","article-title":"Cervical computed tomography in patients with obstructive sleep apnea: influence of head elevation on the assessment of upper airway volume","volume":"42","author":"Souza","year":"2016","journal-title":"J\u00a0Bras Pneumol"},{"issue":"4","key":"10.1016\/j.sleep.2020.09.008_bib14","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s11325-017-1524-3","article-title":"The influence of head-of-bed elevation in patients with obstructive sleep apnea","volume":"21","author":"Souza","year":"2017","journal-title":"Sleep Breath\u00a0= Schlaf & Atmung"},{"issue":"1","key":"10.1016\/j.sleep.2020.09.008_bib15","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s11325-016-1360-x","article-title":"Ulnar nerve entrapment at elbow in obstructive sleep apnea patients: a randomized controlled trial","volume":"21","author":"Bilgin Top\u00e7uo\u011flu","year":"2017","journal-title":"Sleep Breath"},{"issue":"4","key":"10.1016\/j.sleep.2020.09.008_bib16","doi-asserted-by":"crossref","first-page":"307","DOI":"10.5152\/npa.2016.15907","article-title":"Carpal Tunnel Syndrome in obstructive sleep apnea patients","volume":"54","author":"Bilgin Top\u00e7uo\u011flu","year":"2017","journal-title":"Noro Psikiyatr Ars"},{"issue":"3","key":"10.1016\/j.sleep.2020.09.008_bib17","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1007\/s00784-011-0555-6","article-title":"Long-term oral appliance therapy in obstructive sleep apnea syndrome: a controlled study on temporomandibular side effects","volume":"16","author":"Doff","year":"2012","journal-title":"Clin Oral Investig"},{"issue":"6","key":"10.1016\/j.sleep.2020.09.008_bib18","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.ajodo.2003.10.040","article-title":"Influence on the masticatory system in treatment of obstructive sleep apnea and snoring with a mandibular protruding device: a 2-year follow-up","volume":"126","author":"Fransson","year":"2004","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"1","key":"10.1016\/j.sleep.2020.09.008_bib19","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s11325-012-0704-4","article-title":"Negative association between self-reported jaw symptoms and apnea-hypopnea index in patients with symptoms of obstructive sleep apnea syndrome: a pilot study","volume":"17","author":"Kato","year":"2013","journal-title":"Sleep Breath"},{"issue":"suppl_1","key":"10.1016\/j.sleep.2020.09.008_bib20","doi-asserted-by":"crossref","first-page":"S69","DOI":"10.1093\/pm\/pny140","article-title":"The association of obstructive sleep apnea and pain outcomes in adults: a systematic review","volume":"19","author":"Charokopos","year":"2018","journal-title":"Pain Med"},{"key":"10.1016\/j.sleep.2020.09.008_bib21","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.sleep.2018.05.023","article-title":"Sleep disturbances and sleep disorders in adults living with chronic pain: a meta-analysis","volume":"52","author":"Mathias","year":"2018","journal-title":"Sleep Med"},{"issue":"4","key":"10.1016\/j.sleep.2020.09.008_bib22","doi-asserted-by":"crossref","first-page":"E569","DOI":"10.36076\/ppj\/2019.19.E569","article-title":"What is the prevalence of symptomatic obstructive sleep apnea syndrome in chronic spinal pain patients? An assessment of the correlation of OSAS with chronic opioid therapy, obesity, and smoking","volume":"19","author":"Pampati","year":"2016","journal-title":"Pain Phy"},{"issue":"suppl 60","key":"10.1016\/j.sleep.2020.09.008_bib23","first-page":"PA340","article-title":"Obstructive sleep apnea is a risk factor for osteoarthritis","volume":"48","author":"Kanbay","year":"2016","journal-title":"Eur Respir J"},{"issue":"8","key":"10.1016\/j.sleep.2020.09.008_bib24","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1093\/pm\/pnx211","article-title":"An Examination of pain's relationship to sleep fragmentation and disordered breathing across common sleep disorders","volume":"19","author":"Mundt","year":"2018","journal-title":"Pain Med"},{"issue":"5","key":"10.1016\/j.sleep.2020.09.008_bib25","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1002\/acr.22994","article-title":"Association of musculoskeletal joint pain with obstructive sleep apnea, daytime sleepiness, and poor sleep quality in men","volume":"69","author":"Li","year":"2017","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"10.1016\/j.sleep.2020.09.008_bib26","unstructured":"Portland TMJ Clinic. Posture and the bite. http:\/\/portlandtmjclinic.com\/tmjdisorders\/the-role-of-body-posture. Published 2020. [Accessed 22 July 2020]."},{"issue":"3","key":"10.1016\/j.sleep.2020.09.008_bib27","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/0002-9416(80)90081-0","article-title":"Experimental manipulation of head posture","volume":"77","author":"Vig","year":"1980","journal-title":"Am J Orthod"},{"issue":"10","key":"10.1016\/j.sleep.2020.09.008_bib28","first-page":"1440","article-title":"Influence of head extension, flexion, and rotation on collapsibility of the passive upper airway","volume":"31","author":"Walsh","year":"2008","journal-title":"Sleep"},{"issue":"2","key":"10.1016\/j.sleep.2020.09.008_bib29","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/ejo\/15.2.107","article-title":"Head posture in obstructive sleep apnoea","volume":"15","author":"Solow","year":"1993","journal-title":"Eur J Orthod"},{"issue":"4","key":"10.1016\/j.sleep.2020.09.008_bib30","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1055\/s-2004-860896","article-title":"Elevated posture for the management of obstructive sleep apnea","volume":"8","author":"Skinner","year":"2004","journal-title":"Sleep Breath"},{"issue":"1","key":"10.1016\/j.sleep.2020.09.008_bib31","first-page":"e72","article-title":"Oral appliance therapy in obstructive sleep apnea: Long-term adherence and patients experiences","volume":"23","author":"Saglam-Aydinatay","year":"2018","journal-title":"Med Oral Patol Oral Cir Bucal"},{"issue":"1","key":"10.1016\/j.sleep.2020.09.008_bib32","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1164\/ajrccm.159.1.9709051","article-title":"Peripheral neuropathy in sleep apnea. a tissue marker of the severity of nocturnal desaturation","volume":"159","author":"Mayer","year":"1999","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"10.1016\/j.sleep.2020.09.008_bib33","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1007\/s11552-010-9308-2","article-title":"Preferred sleep position on the side is associated with carpal tunnel syndrome","volume":"6","author":"McCabe","year":"2011","journal-title":"Hand"},{"issue":"17","key":"10.1016\/j.sleep.2020.09.008_bib34","doi-asserted-by":"crossref","first-page":"2660","DOI":"10.1161\/CIRCULATIONAHA.105.556746","article-title":"Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome","volume":"112","author":"Ryan","year":"2005","journal-title":"Circulation"},{"issue":"8","key":"10.1016\/j.sleep.2020.09.008_bib35","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1111\/j.1365-2362.2008.01984.x","article-title":"Selective effects of CPAP on sleep apnoea-associated manifestations","volume":"38","author":"Vgontzas","year":"2008","journal-title":"Eur J Clin Invest"},{"issue":"7","key":"10.1016\/j.sleep.2020.09.008_bib36","first-page":"844","article-title":"Sleep fragmentation hypersensitizes healthy young women to deep and superficial experimental pain","volume":"18","author":"Iacovides","year":"2017","journal-title":"J\u00a0Pain"},{"issue":"10","key":"10.1016\/j.sleep.2020.09.008_bib37","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/S0003-9969(00)00044-3","article-title":"Sleep bruxism in patients with sleep-disordered breathing","volume":"45","author":"Sj\u00f6holm","year":"2000","journal-title":"Arch Oral Biol"},{"key":"10.1016\/j.sleep.2020.09.008_bib38","first-page":"399","article-title":"The association between chronic pain and obesity","volume":"8","author":"Okifuji","year":"2015","journal-title":"J\u00a0Pain Res"},{"issue":"9","key":"10.1016\/j.sleep.2020.09.008_bib39","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jamda.2010.04.003","article-title":"Pain tolerance and obstructive sleep apnea in the elderly","volume":"11","author":"Onen","year":"2010","journal-title":"J\u00a0Am Med Dir Assoc"},{"issue":"10","key":"10.1016\/j.sleep.2020.09.008_bib40","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1111\/j.1460-9568.1996.tb00728.x","article-title":"Pain perception under chronic high-altitude hypoxia","volume":"8","author":"No\u00ebl-Jorand","year":"1996","journal-title":"Eur J Neurosci"}],"container-title":["Sleep Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1389945720304111?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1389945720304111?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T15:22:19Z","timestamp":1761405739000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1389945720304111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":40,"alternative-id":["S1389945720304111"],"URL":"https:\/\/doi.org\/10.1016\/j.sleep.2020.09.008","relation":{},"ISSN":["1389-9457"],"issn-type":[{"value":"1389-9457","type":"print"}],"subject":[],"published":{"date-parts":[[2020,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Obstructive sleep Apnea's association with the cervical spine abnormalities, posture, and pain: a systematic review","name":"articletitle","label":"Article Title"},{"value":"Sleep Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.sleep.2020.09.008","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Published by Elsevier B.V.","name":"copyright","label":"Copyright"}]}}