Surface ultrasound measurement was able to identify both airway and nonairway parameters with moderate to good correlation with obstructive sleep apnea (OSA) diagnosis in the general population, according to meta-analysis results published in Anesthesia & Analgesia.

Researchers conducted a literature search for either observational cohort studies or randomized controlled trials of patients with known or suspected OSA undergoing noninvasive ultrasound assessment. Results were screened for inclusion by 2 independent reviewers with the ability to resolve conflict with supervising authors. The association between ultrasound parameters and OSA diagnosis via sleep study were then evaluated.

Of the 3865 initial search hits, 2581 studies were screened after duplicates were removed. A total of 69 articles were included for full-text screening and 21 studies were ultimately included in the analysis. Of these, 7 studies assessed airway parameters and 14 assessed nonairway parameters.

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The following airway ultrasound parameters were correlated to moderate to severe OSA: distance between lingual arteries, mean resting tongue thickness, tongue base thickness during Muller maneuver, and a combination of neck circumference and retropalatal diameter shortening during Muller maneuver. The nonairway ultrasound parameters that correlated to moderate to severe OSA were carotid intimal thickness and the presence of plaque.

It is important to note that although many airway and nonairway parameters were found to be associated with OSA diagnosis, there was significant heterogeneity and scarcity of well-designed studies to validate ultrasound as a useful screening tool, according to the researchers.

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“This is a new exciting area of investigation, and future studies should build on this work to determine whether a perioperative [point-of-care ultrasound] can further improve diagnostic accuracy of OSA questionnaire-based tools,” the researchers concluded.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Singh M, Tuteja A, Wong DT, et al. Point-of-care ultrasound for obstructive sleep apnea screening: are we there yet? A systematic review and meta-analysis. Anesth Analg. 2019;129(6):1673-1691.