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Scientific Oral Presentation

Sleep Medicine

Characterizing Features of Complete Concentric Collapse in Patients with Obstructive Sleep Apnea

Sunday, October 18, 2026
11:36 AM - 11:42 AM PT
Location: 403B

    Presenting Author(s)

  • BY

    Brian F. Yee, BS

    Medical Student
    Rush Medical College
    Chicago, IL, United States

    • Co-Author(s)

  • MB

    Muhammad R. Bux, BA

    Medical Student
    Rush Medical College
    Chicago, Illinois, United States

  • Robin A. Powszok, MD

    PGY-4
    Rush University Medical Center
    Chicago, IL, United States

    • Senior Author(s)

  • Michael J. Hutz, MD

    Assistant Professor, Section Head of Sleep Surgery
    Rush University Medical Center
    Elmhurst, Illinois, United States

Disclosure(s):
Brian F. Yee, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Patients with a complete concentric collapse (CCC) pattern as noted on drug-induced sleep endoscopy (DISE) often have more severe obstructive sleep apnea (OSA) with more limited treatment options versus those with anteroposterior collapse (AP). Despite their significance, the craniofacial associations with these patterns remain limited and are evaluated in our study.

Methods: This was a retrospective cohort study of CPAP-intolerant OSA patients (AHI>5 events/hour) who underwent DISE-PAP and standardized preop CT imaging. Craniofacial measurements were obtained in a double-blinded fashion by 2 reviewers using InVivo 7, a 3D medical imaging software. Demographic and anthropometric data were obtained from medical records.

Results: Of 211 patients, 128 had AP collapse and 41 with CCC. The cohort was predominantly male (73%), White (65%), middle-aged (52.5 + 13.4 years), and obese (BMI 30.2 + 4.6) with severe OSA (AHI 3% 37.6 events/hour). CCC was more common among African American patients, while AP collapse more frequent in White patients (p < 0.001). CCC patients had higher average BMI (31.9 vs 29.6 kg/m2, p = 0.005), younger age (47.9 vs 54.0, p = 0.006), greater OSA severity (AHI 45.93 vs 34.97, p = 0.037), higher average PhOP (10.15 cm H20 vs 7.83 cm H2O), more inferior positioned hyoid (17.13 mm vs 14.19 mm, p = 0.038), higher SNA and SNB angles (p < 0.001), and greater intermolar and interpremolar mandibular width, and greater interpremolar distance. Intraclass Correlation Coefficients for the measurements demonstrated good to excellent reliability (ICC 0.802 - 0.990). All other variables were not significant.

Conclusions: CCC patients were more likely to have increased BMI, increased OSA severity, more severe upper airway collapsibility, and increased airway length. Interestingly, maxillary hypoplasia and retrognathia showed greater predominance in AP patients. This study provides further information on anatomic and physiologic features of patients with CCC which may improve patient selection and outcomes for sleep surgery evaluation.