{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:52:49Z","timestamp":1788540769000,"version":"build-2803163510"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01HL089447"],"award-info":[{"award-number":["R01HL089447"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["P01HL094307"],"award-info":[{"award-number":["P01HL094307"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","award":["201508440455"],"award-info":[{"award-number":["201508440455"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Obesity 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate upper airway anatomic characteristics and airway compliance (distensibility) in obese subjects with obstructive sleep apnea compared with obese control subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Dynamic 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\u2013hypopnea index among subjects with apnea, were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Measurements 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\u2009=\u20090.003), maximum (P\u2009=\u20090.004), and minimum (P\u2009=\u20090.001) airway area. Airway narrowing was observed in anteroposterior and lateral dimensions (adjusted P\u2009&amp;lt;\u20090.05). Results were similar in an age, sex, and body mass index\u2013matched subsample. There were significant correlations between apnea\u2013hypopnea index and dynamic measures of airway caliber in the retropalatal and retroglossal regions among subjects with apnea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Upper 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201711-2171oc","type":"journal-article","created":{"date-parts":[[2018,7,24]],"date-time":"2018-07-24T17:56:21Z","timestamp":1532454981000},"page":"1435-1443","source":"Crossref","is-referenced-by-count":38,"title":["Dynamic Upper Airway Imaging during Wakefulness in Obese Subjects with and without Sleep Apnea"],"prefix":"10.1093","volume":"198","author":[{"given":"Yuan","family":"Feng","sequence":"first","affiliation":[{"name":"Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China; and"},{"name":"Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan T.","family":"Keenan","sequence":"additional","affiliation":[{"name":"Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Leinwand","sequence":"additional","affiliation":[{"name":"Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Wiemken","sequence":"additional","affiliation":[{"name":"Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan I.","family":"Pack","sequence":"additional","affiliation":[{"name":"Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Schwab","sequence":"additional","affiliation":[{"name":"Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,12,1]]},"reference":[{"key":"2026032023290416500_bib1","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/S0140-6736(02)09464-3","article-title":"Obstructive sleep apnoea","volume":"360","author":"Malhotra","year":"2002","journal-title":"Lancet"},{"key":"2026032023290416500_bib2","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1513\/pats.200708-137MG","article-title":"Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches","volume":"5","author":"Schwartz","year":"2008","journal-title":"Proc Am Thorac Soc"},{"key":"2026032023290416500_bib3","doi-asserted-by":"crossref","first-page":"311","DOI":"10.2214\/ajr.160.2.8424340","article-title":"Evaluation of the pharyngeal airway in patients with sleep apnea: value of ultrafast MR imaging","volume":"160","author":"Suto","year":"1993","journal-title":"AJR Am J Roentgenol"},{"key":"2026032023290416500_bib4","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1164\/ajrccm\/148.5.1385","article-title":"Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing","volume":"148","author":"Schwab","year":"1993","journal-title":"Am Rev Respir Dis"},{"key":"2026032023290416500_bib5","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1148\/radiology.171.3.2717750","article-title":"Obstructive sleep apnea: diagnosis with ultrafast CT","volume":"171","author":"Galvin","year":"1989","journal-title":"Radiology"},{"key":"2026032023290416500_bib6","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.2214\/ajr.148.6.1069","article-title":"Cine CT in obstructive sleep apnea","volume":"148","author":"Stein","year":"1987","journal-title":"AJR Am J Roentgenol"},{"key":"2026032023290416500_bib7","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1164\/ajrccm.152.5.7582313","article-title":"Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. 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