Facial Structure, OSA, and CPAP: Problems and Solutions



Human evolution shows us that there are distinct variations in facial structure and features. Anthropologists have been examining these traits for some time to see if ancestry plays a role in this diversification. Other research has been conducted to see if your facial structure and features has any connections with certain problems.

For instance, did you know that your facial structure is determined by your genes and can actually affect how you breathe?

Different Facial Types and Features

One thing scientists have proven is that genetics plays a role in the outcome of your facial features. Both Mendel's laws (the principals or segregation and independent assortment) and the genes of your mother and father influence your physical features, also referred to as a 'phenotype'.

Human phenotype dictates if a person will have a prominent nose, round or long face, brown hair, blue eyes, separated earlobes, and so forth.

Evidence has pointed out that the shape of your face is controlled by your genes; however, scientists have yet to discover how this genetic variation does in fact contribute to the different sizes and shapes that human faces develop into.

In order to identify and get an understanding of these variants, scientists performed  a genome-wide association study  in which they measured 20 facial features of 3,118 people with European ancestry backgrounds and around a million single nucleotide polymorphisms variations (SNPs) all over the genome.

Certain SNPs were statistically associated with characteristics such as:

Results from a couple other previously conducted genome-wide association studies were also used to confirm their findings. Several facial feature genetic associations were identified through their analysis that weren't found in previous studies.

Scientists can use these findings to give them insight and improve their understanding of how genes dictate the formation of your face as well as other factors that lead to some types of craniofacial birth defects. Researchers did detect there were certain genetic regions that contributed to face shape that contained genes which are known to contribute to facial abnormalities and development.

Some features like your eye color, hair color and skin color are controlled by more than two genes. For instance:

In another study involving 6,275 Latin Americans, scientists studied forehead profile, lip thickness, brow protrusion, cheekbone protrusion, the shape of the nose and other facial features. They found that one or more genes dictated the formation of each feature. There were five  genes in particular: GLI3, PAX1, DCHS2, RUNX2 and EDAR.

EDAR is the gene that influences chin protrusion. The other four regulate the bone mass that shapes facial features and how your cartilaginous tissue grows on your body. Genetic makeup for the nose includes the RUNX2, DCHS2, PAX1 and GLI3. The gene DCHS2 controls nose prominence while GLI3 and PAX1 control the nostrils. The formation of your nasal bones is controlled by the RUNX2 gene as well as the overall width of the bridge of your nose.

How Your Face Shape Impacts How You Breathe

Now that you know about the different facial types and features, you have a better background to understand how your face shape influences your breathing.

In a study, the relationships between 3 factors were studied:

1. Facial Types (mesofacial, brachyfacial and dolichofacial)

2. Facial Morphological Patterns (Patterns I, II and III as well as Short and Long Face)

3. Obstructive Sleep Apnea (OSA)

The study involved smile, lateral and frontal photos of 252 patients (95 women and 157 men) who were at the average age of 40 were selected from a polysomnography clinic and evaluated.


The researchers found that the facial morphology of the patients influenced OSA. Brachyfacial and Pattern II patients had a higher apnea and hypopnea index (AHI) and the patients in the Pattern III group displayed a lower index.

In layman’s terms, the study found that certain facial structure features, such as distance between the eyes, width of the face, the chin to neck angle, and the length of the face all were helpful in predicting obstructive sleep apnea.

Proper Fitting of Your CPAP Mask

The bottom line is that all of this technical information about your facial structure supports the fact that the shape of your face impacts the way you breathe and how your CPAP mask will fit.  There are a number of different sizes and styles of CPAP masks. Since everyone’s' face is shaped different as we just described, one size mask might be good for one person, but not another. That’s why there needs to be a good match up between your facial structure and CPAP mask.

It’s important that you find a CPAP mask that is specific for the shape of your face. Each night, you will be wearing your mask as part of your therapy and you will want to have a comfortable fit that matches the shape of your face so you can get a good night's sleep.

Masks come in a number of sizes and shapes just like people's face.  There are several categories that masks fall under including:

You may need to try out several CPAP masks to find the one that works best for you or if you are having CPAP problems. Your best bet is to have your sleep therapist or doctor fit your mask to your face shape to ensure proper sizing. If you wish to size your own mask, you will have to ensure you take proper measurements of your face.

It might take a little research and trial and error for you to find the size and style that provides you with both efficiency and comfort.  It’s a good idea to work with a sleep clinic that offer patients unlimited trials and fittings.  When your CPAP mask is the right size and quality, you will be able to get a more restful sleep which will increase your productivity the next day.

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