O'donoghue FJ, et al. - In this present study, the physicians examined upper airway anatomy in quadriplegics with obstructive sleep apnea. Compared to able-bodied subjects, people with obstructive sleep apnea and quadriplegia did not have a structurally smaller airway. However, they did have greater volumes of the soft palate and lateral pharyngeal walls, possibly because of greater neck fat deposition. In those with obstructive sleep apnea and quadriplegia, the acute response to upper airway topical vasoconstriction was not enhanced. Changes in upper airway anatomy likely contributed to the high incidence of obstructive sleep apnea in quadriplegic subjects.