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a Sleep Laboratory,
Respiratory Medicine Unit, Royal Infirmary of Edinburgh, Edinburgh EH3
9YW, UK, b Department of Medical Physics and Medical
Engineering, c Department of Clinical Neurosciences, d Western
General Hospital, Edinburgh EH4 2XU, UK
Correspondence to: Dr A T Whittle.
Received 25 June 1998; Returned to authors 17 August 1998; Revised version received 18 September 1998; Accepted for publication 17 November 1998
BACKGROUND
Obesity and
increased neck circumference are risk factors for the obstructive sleep
apnoea/hypopnoea syndrome (SAHS). SAHS is more common in men than in
women, despite the fact that women have higher rates of obesity and
greater overall body fat. One factor in this apparently paradoxical sex
distribution may be the differing patterns of fat deposition adjacent
to the upper airway in men and women. A study was therefore undertaken
to compare neck fat deposition in normal men and women.
METHODSUsing T1
weighted magnetic resonance imaging, the fat and tissue volumes in the
necks of 10 non-obese men and 10 women matched for age (men mean (SE)
36 (3) years, women 37 (3) years, p = 0.7), body mass index (both 25 (0.6) kg/m2, p>0.9), and Epworth Sleepiness Score (both 5 (1), p = 0.9) were assessed; all denied symptoms of SAHS.
RESULTSTotal neck
soft tissue volume was greater in men (1295 (62) vs 928 (45) cm3, p<0.001), but the volume of fat did not differ
between the sexes (291 (29) vs 273 (18) cm3, p = 0.6). The
only regions impinging on the pharynx which showed a larger absolute
volume of fat in men (3.2 (0.7) vs 1.1 (0.3) cm3, p = 0.01) and also a greater proportion of neck fat in men (1.3 (0.3)% vs
0.4 (0.1)%, p = 0.03) were the anterior segments inside the mandible
at the palatal level.
CONCLUSIONSThere are
differences in neck fat deposition between the sexes which, together
with the greater overall soft tissue loading on the airway in men, may
be factors in the sex distribution of SAHS.
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