Biomechanical Characteristics of Upper Airway Muscles and Their Association with Obstructive Sleep Apnea Risk in Industrial Workers

Abstract

Background Obstructive Sleep Apnea Syndrome (OSAS) is characterized by repetitive upper airway obstruction during sleep. The viscoelastic properties of accessory respiratory muscles may play a compensatory role in maintaining airway patency. This study aimed to investigate the association between OSAS risk and muscle biomechanics in industrial workers. Methods This cross-sectional study included 236 male industrial workers aged 18-55, categorized into low, moderate, and high OSAS risk groups using the STOP-BANG questionnaire. The viscoelastic properties (tone, stiffness, elasticity) of the genioglossus, sternocleidomastoid, and masseter muscles were assessed using the MyotonPRO device. Sociodemographic and occupational data were collected. Statistical analyses included Kruskal-Wallis and Spearman correlation tests and additionally, univariate and multivariate linear regression. Results A significant difference was found only in left genioglossus tone across STOP-BANG risk groups (p < 0.05). Age and BMI were moderately associated with increased muscle stiffness and reduced elasticity, particularly in the SCM and masseter muscles. In regression analyses, right SCM stiffness and BMI were significant in the univariate model; however, after adjusting for age, BMI, smoking and duration of employment, only right SCM stiffness remained an independent predictor of STOP-BANG score (beta approximate to 0.01, p < 0.05). Conclusions Muscle viscoelastic properties are influenced not only by OSAS risk but also by age, BMI, occupational exposure, and smoking. Importantly, SCM stiffness may serve as a potential biomechanical marker associated with OSAS risk. Muscle biomechanics assessments could be used as a supportive, non-invasive screening tool in high-risk occupational populations.