Daniel Kuhn, D.C.
This case report of a 51 year old male patient has two objectives. The first is to present the occiput and upper cervical curve of a patient, who over a course of 21 years of chiropractic care developed severe Obstructive Sleep Apnea Syndrome (OSAS). This presentation compares the upper cervical spine and occiput with previous findings which suggest a relationship between upper cervical kyphosis and OSAS severity in a population of male OSAS patients. Data relative to patient care and frequency of visits and adjustments, as well as body weight (a proposed risk factor and characteristic of male OSAS patients), were compared relative to changes in the magnitude of the occiput, atlas, occiput/axis, and atlas/axis angles, over similar time periods. Results revealed that body weight was significant, and positively correlated with an increase in flexion of the atlas/occiput, while chiropractic parameters showed no influence on the magnitude of any of the angles measured.The second objective of the report was to emphasize the importance of monitoring predisposing factors which could affect cervical curvature in a manner contrary to expectations of the chiropractic care delivered. Present findings support the presumption that excess body weight contributes to OSAS severity, as the patient studied expressed severe OSAS at a time when his weight elevated from 195 pounds to 455 pounds over a period of 18 years. Since his weight gain and approximate concomitant upper cervical kyphosis were also evident, this finding also supports previous study suggesting a similar relationship. A plausible model for the evolution of the upper cervical kyphosis, and suggestions for future study, are also discussed.
Key words: vertebral subluxation, Obstructive Sleep Apnea Syndrome; OSAS, cervical kyphosis, sleep study, obesity