Sleep apnea, affecting an estimated 1 in 4 American adults, has been reported to be associated with both brain structural abnormality and impaired cognitive function. Obstructive sleep apnea is known to be affected by upper airway anatomy. To better understand the contribution of upper airway anatomy to pathways linking sleep apnea with impaired cognitive function, we investigated the association of upper airway anatomy with structural brain abnormalities. Based in the Multi-Ethnic Study of Atherosclerosis, a longitudinal cohort study of community-dwelling adults, a comprehensive sleep study and an MRI of the upper airway and brain were performed on 578 participants. Machine learning models were used to select from 74 upper airway measures those measures most associated with selected regional brain volumes and white matter hyperintensity volume. Linear regression assessed associations between the selected upper airway measures, sleep measures, and brain structure. Maxillary divergence was positively associated with hippocampus volume, and mandible length was negatively associated with total white and gray matter volume. Both coefficients were small (coefficients per standard deviation 0.063 mL, p = 0.04, and − 7.0 mL, p < 0.001 respectively), and not affected by adjustment for sleep study measures. Self-reported snoring >2 times per week was associated with larger hippocampus volume (coefficient 0.164 mL, p = 0.007), and higher percentage of time in the N3 sleep stage was associated with larger total white and gray matter volume (4.8 mL, p = 0.004). Despite associations of two upper airway anatomy measures with brain volume, the evidence did not suggest that these upper airway and brain structure associations were acting primarily through the pathway of sleep disturbance.

据报道，睡眠呼吸暂停影响了大约四分之一的美国成年人，它与大脑结构异常和认知功能受损有关。已知阻塞性睡眠呼吸暂停受上呼吸道解剖结构的影响。为了更好地了解上呼吸道解剖结构对睡眠呼吸暂停与认知功能受损之间的联系的影响，我们研究了上呼吸道解剖结构与大脑结构异常的关联。基于动脉粥样硬化多种族研究，对 578 名参与者进行了一项针对社区居住成年人的纵向队列研究、一项全面的睡眠研究以及上呼吸道和大脑的 MRI 扫描。使用机器学习模型从 74 项上呼吸道测量中选择与选定区域脑容量和白质高信号体积最相关的测量。线性回归评估了所选上呼吸道测量、睡眠测量和大脑结构之间的关联。上颌分歧与海马体积呈正相关，下颌长度与白质和灰质总体积呈负相关。两个系数都很小（每标准差的系数分别为 0.063 mL，p = 0.04 和 − 7.0 mL，p < 0.001），并且不受睡眠研究测量调整的影响。自我报告的打鼾每周 >2 次与较大的海马体体积相关（系数 0.164 mL，p = 0.007），N3 睡眠阶段的时间百分比较高与较大的总白质和灰质体积相关（4.8 mL，p = 0.007） = 0.004）。尽管两种上气道解剖测量与脑容量存在关联，但证据并不表明这些上气道和大脑结构关联主要通过睡眠障碍途径发挥作用。