What is the strongest indicator for obstructive sleep apnea?

• A. Neck circumference
• B. Body Mass Index
• C. Mallampati score
• D. Snoring frequency

Answer: (A)

The strongest single indicator for obstructive sleep apnea is neck circumference. A larger neck means more soft tissue around the upper airway, which narrows the pharyngeal lumen and increases its tendency to collapse during sleep. This anatomical crowding directly raises the risk and potential severity of airway obstruction.

Body mass index rises with overall body fat but doesn’t specifically reflect airway size or collapsibility, so it’s a weaker standalone predictor. The Mallampati score assesses airway visualization for anesthesia and doesn’t reliably predict sleep-disordered breathing. Snoring frequency is common in many people, including those without OSA, so it’s not as specific or predictive. In screening tools like STOP-BANG, neck circumference is a key factor for risk assessment.