{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:31:33Z","timestamp":1787031093312,"version":"build-2736575974"},"reference-count":26,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2016,8,16]],"date-time":"2016-08-16T00:00:00Z","timestamp":1471305600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The purpose of this observational study was to investigate the relationship between upper-airway configuration assessed by CT imaging during the M\u00fcller maneuver state and the severity of obstructive sleep apnea syndrome (OSAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A total of 358 snoring subjects who underwent standard polysomnography and upper-airway configuration by using CT imaging were enrolled. According to the apnea-hypopnea index (AHI), subjects were classified into 4 groups: snoring group (simple snoring), AHI &lt; 5; mild OSAS, 5 \u2264 AHI &lt; 15; moderate OSAS, 15 \u2264 AHI &lt; 30; and severe OSAS, AHI \u2265 30. We also divided the upper airway into 3 parts, named the nasopharynx, oropharynx, and hypopharynx, from the CT scan and evaluated the minimal cross-sectional area (mCSA) and the shape of each airway level and calculated upper-airway length and distance from mandibular plane to hyoid bone (MPH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Multivariate logistic stepwise regression analysis identified body mass index (BMI), mCSA of nasopharynx, upper-airway length, and MPH as risk factors for the severity of OSAS. When subdivided for BMI and sex, upper-airway length was a risk factor for OSAS in non-obese (BMI &lt; 27 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) and male subjects, and MPH was a risk factor only in obese (BMI \u2265 27 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) subjects. Meanwhile, mCSA of nasopharynx was significantly associated with the severity of OSAS independent of BMI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Subjects with severe OSAS have more significant abnormalities of the upper airway. Obesity, mCSA of nasopharynx, upper-airway length, and MPH may contribute to the severity of OSAS. Obesity and sex should be taken into account when evaluating the abnormalities of upper-airway anatomy in snorers and patients with OSAS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.04669","type":"journal-article","created":{"date-parts":[[2016,8,16]],"date-time":"2016-08-16T22:48:42Z","timestamp":1471387722000},"page":"1651-1658","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Assessment of Upper-Airway Configuration in Obstructive Sleep Apnea Syndrome With Computed Tomography Imaging During M\u00fcller Maneuver"],"prefix":"10.1177","volume":"61","author":[{"given":"Jie-Feng","family":"Huang","sequence":"first","affiliation":[{"name":"Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Taijiang District, Fuzhou, Fujian Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gong-Ping","family":"Chen","sequence":"additional","affiliation":[{"name":"Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Taijiang District, Fuzhou, Fujian Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bi-Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Taijiang District, Fuzhou, Fujian Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-Sheng","family":"Xie","sequence":"additional","affiliation":[{"name":"Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Taijiang District, Fuzhou, Fujian Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Ming","family":"Zhao","sequence":"additional","affiliation":[{"name":"Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Taijiang District, Fuzhou, Fujian Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Hua","family":"Wu","sequence":"additional","affiliation":[{"name":"Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Taijiang District, Fuzhou, Fujian Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Da","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Xiangcheng, Zhangzhou, Fujian Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi-Chang","family":"Lin","sequence":"additional","affiliation":[{"name":"Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, First Affiliated Hospital of Fujian Medical University, Taijiang District, Fuzhou, Fujian Province, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,8,16]]},"reference":[{"issue":"1","key":"e_1_3_2_2_2","first-page":"11","article-title":"From snoring to sleep apnea in a Singapore population","volume":"2","author":"Puvanendran K","year":"1999","unstructured":"Puvanendran K, , Goh KL. From snoring to sleep apnea in a Singapore population. 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