The Obstructive Sleep Apnea Physical Exam: A Systematic Review and Meta‐Analysis
ABSTRACT Introduction This systematic review aimed to determine the clinical utility of various physical exam findings in the diagnosis of obstructive sleep apnea (OSA). Methods A systematic review of English articles identified from PubMed, Embase, CENTRAL, and Web of Science databases. Search term...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | Laryngoscope Investigative Otolaryngology |
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| Online Access: | https://doi.org/10.1002/lio2.70154 |
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| author | Nihal Punjabi Roy W. Qu Alexandra Vacaru Brianna Pandey Shanalee Tamares Jared C. Inman |
| author_facet | Nihal Punjabi Roy W. Qu Alexandra Vacaru Brianna Pandey Shanalee Tamares Jared C. Inman |
| author_sort | Nihal Punjabi |
| collection | DOAJ |
| description | ABSTRACT Introduction This systematic review aimed to determine the clinical utility of various physical exam findings in the diagnosis of obstructive sleep apnea (OSA). Methods A systematic review of English articles identified from PubMed, Embase, CENTRAL, and Web of Science databases. Search terms included “sleep apnea,” “physical exam,” “polysomnography,” and all relevant synonyms. Two reviewers independently screened abstracts, reviewed full texts, and extracted data from all studies that presented associations between physical characteristics and apnea‐hypopnea index (AHI). Results A total of 35 studies representing 13,854 patients were included in this review. The mean difference between high AHI and low AHI groups was 4.09 kg/m2 (95% CI: 2.78–5.39) for BMI, 7.93 cm (3.59–12.28) for waist circumference, and 3.67 cm (2.64–4.71) for neck circumference. The odds ratios for having a high AHI were 2.44 (1.07–5.55) for macroglossia, 2.23 (1.68–2.96) for Mallampati > 2, 1.88 (1.67–2.11) for tonsil grade > 2, 3.99 (1.94–8.21) for pharyngeal grade > 2, and 1.57 (1.48–1.67) for enlarged uvula. Thyromental distance, retrognathia, Friedman grade, septal deviation, and enlarged turbinates were also assessed and were not found to be statistically significant between AHI groups. Discussion Several physical exams have strong evidence in the literature supporting their strength at differentiating patients with and without OSA. These should be used routinely among providers who treat OSA, regardless of specialty, to help guide decisions about recommending a sleep study and selecting appropriate treatment. Other physical characteristics may be better assessed through advanced exam techniques or require more research and standardization in the way they are assessed by practitioners. |
| format | Article |
| id | doaj-art-0692cf2c1d5c42688d1ea72a301d3eba |
| institution | Kabale University |
| issn | 2378-8038 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj-art-0692cf2c1d5c42688d1ea72a301d3eba2025-08-20T03:28:00ZengWileyLaryngoscope Investigative Otolaryngology2378-80382025-06-01103n/an/a10.1002/lio2.70154The Obstructive Sleep Apnea Physical Exam: A Systematic Review and Meta‐AnalysisNihal Punjabi0Roy W. Qu1Alexandra Vacaru2Brianna Pandey3Shanalee Tamares4Jared C. Inman5Department of Otolaryngology—Head and Neck Surgery Loma Linda University Health Loma Linda California USADepartment of Otolaryngology—Head and Neck Surgery Loma Linda University Health Loma Linda California USALoma Linda University School of Medicine Loma Linda California USADepartment of Otolaryngology—Head and Neck Surgery Loma Linda University Health Loma Linda California USAUniversity Libraries, Loma Linda University Loma Linda California USADepartment of Otolaryngology—Head and Neck Surgery Loma Linda University Health Loma Linda California USAABSTRACT Introduction This systematic review aimed to determine the clinical utility of various physical exam findings in the diagnosis of obstructive sleep apnea (OSA). Methods A systematic review of English articles identified from PubMed, Embase, CENTRAL, and Web of Science databases. Search terms included “sleep apnea,” “physical exam,” “polysomnography,” and all relevant synonyms. Two reviewers independently screened abstracts, reviewed full texts, and extracted data from all studies that presented associations between physical characteristics and apnea‐hypopnea index (AHI). Results A total of 35 studies representing 13,854 patients were included in this review. The mean difference between high AHI and low AHI groups was 4.09 kg/m2 (95% CI: 2.78–5.39) for BMI, 7.93 cm (3.59–12.28) for waist circumference, and 3.67 cm (2.64–4.71) for neck circumference. The odds ratios for having a high AHI were 2.44 (1.07–5.55) for macroglossia, 2.23 (1.68–2.96) for Mallampati > 2, 1.88 (1.67–2.11) for tonsil grade > 2, 3.99 (1.94–8.21) for pharyngeal grade > 2, and 1.57 (1.48–1.67) for enlarged uvula. Thyromental distance, retrognathia, Friedman grade, septal deviation, and enlarged turbinates were also assessed and were not found to be statistically significant between AHI groups. Discussion Several physical exams have strong evidence in the literature supporting their strength at differentiating patients with and without OSA. These should be used routinely among providers who treat OSA, regardless of specialty, to help guide decisions about recommending a sleep study and selecting appropriate treatment. Other physical characteristics may be better assessed through advanced exam techniques or require more research and standardization in the way they are assessed by practitioners.https://doi.org/10.1002/lio2.70154apnea‐hypopnea indexmeta‐analysisobstructive sleep apneaphysical exampolysomnography |
| spellingShingle | Nihal Punjabi Roy W. Qu Alexandra Vacaru Brianna Pandey Shanalee Tamares Jared C. Inman The Obstructive Sleep Apnea Physical Exam: A Systematic Review and Meta‐Analysis Laryngoscope Investigative Otolaryngology apnea‐hypopnea index meta‐analysis obstructive sleep apnea physical exam polysomnography |
| title | The Obstructive Sleep Apnea Physical Exam: A Systematic Review and Meta‐Analysis |
| title_full | The Obstructive Sleep Apnea Physical Exam: A Systematic Review and Meta‐Analysis |
| title_fullStr | The Obstructive Sleep Apnea Physical Exam: A Systematic Review and Meta‐Analysis |
| title_full_unstemmed | The Obstructive Sleep Apnea Physical Exam: A Systematic Review and Meta‐Analysis |
| title_short | The Obstructive Sleep Apnea Physical Exam: A Systematic Review and Meta‐Analysis |
| title_sort | obstructive sleep apnea physical exam a systematic review and meta analysis |
| topic | apnea‐hypopnea index meta‐analysis obstructive sleep apnea physical exam polysomnography |
| url | https://doi.org/10.1002/lio2.70154 |
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