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. 2025 Jul 31;24(1):135-140.
doi: 10.1007/s41105-025-00602-y. eCollection 2026 Jan.

Craniofacial photography for detection of positional obstructive sleep apnoea

Kate Sutherland  1   2 , John Wheatley  2   3   4 , Kristina Kairaitis  2   3   4 , Brendon J Yee  5   6   7 , Gary Cohen  8 , Kerri Melehan  5 , Stephen Lambert  4 , Philip de Chazal  7 , Peter A Cistulli  1   2   8 ; Sydney Sleep Biobank Investigators
Collaborators, Affiliations

Craniofacial photography for detection of positional obstructive sleep apnoea

Kate Sutherland et al. Sleep Biol Rhythms. .

Abstract

Supine-dependent OSA is a well-recognised OSA phenotype and may relate to craniofacial structure. Our aim was to assess whether craniofacial photos are able to identify positional OSA, specifically supine-isolated OSA, in comparison to non-positional OSA. Frontal and profile craniofacial photographs of participants were acquired according to a standardised protocol. Photographs were analysed and compared between non-positional and supine-isolated OSA groups. A total of 156 OSA patients were included (54.5% supine-isolated OSA, 45.5% with non-positional OSA). The supine-isolated group had a longer upper face height and greater upper-to-lower face height ratio, smaller face width, reduced face width-to-height ratio, and smaller mandibular width, length, and size of the mandibular base. Differences in facial measurements were no longer significant after adjustment for body size and OSA severity. Our study demonstrates that supine-isolated OSA can be identified using facial photography. Larger studies in groups matched for BMI and OSA severity are needed to confirm whether this technique may also capture other features related to supine-isolated OSA (i.e., differences in underlying skeletal structure).

Keywords: Craniofacial phenotype; Obstructive sleep apnoea; Supine position.

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Conflict of interest statement

Conflict of interestPAC has an appointment to an endowed academic Chair at the University of Sydney that was established from ResMed funding, has received research support from ResMed and SomnoMed, and is a consultant to ResMed and SomnoMed, Signifier Medical Technologies, Bayer, and Sunrise Medical. All other authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Craniofacial landmarks used to calculate measurements from front and profile facial photographs. The landmarks used in this analysis are nasion (n), subnasion (sn), menton (me), tragion (t), gonion (go), sublabiale (sl), neck plane point (np), and cervical point (cer). The circular nylon calibration marker which allows quantitative measurements to be obtained can be seen on the side of the face. Measurement definitions: upper face height = n-sn; lower face height = sn-me; face width = t-t; cranial base triangle area = t-n-t; mandibular width = go-go; mandibular length = gn-go; mandibular angle = t-go-gn; mandibular base angle = go-me-go; mandibular base angle = go-me-go; maxilla depth angle = t-n-sn; mandible depth angle = t-n-sl; maxilla–mandible relationship angle; sn-n-sl; cervicomental angle = np-cer-me
See this image and copyright information in PMC

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