## 4 Discussion  
The Berlin Questionnaire was initially used as a screening survey for sleep related breathing disorders by [PERSON] et al. Its sensitivity, specificity, positive and negative predictive value in reference to polysomnography derived data amounted to 67.4%, 52.9%, 66.0% and 54.5%, respectively [24]. In our study, breathing-related problems coincide with higher BMI scores, higher MMP, and lower UAV. Furthermore, it is noteworthy that significantly higher MMP score and BMI correlate with significantly lower SpO2 and UAV. The [PERSON] scale is a simple four-grade score that can also support physician assessment of patient's UAV, as a part of the physical examination prior to a polysomnography referral [25]. This score and the presence and severity of OSA correlation suggest its practical value in clinical settings and prospective studies of sleep-disordered breathing. However, it was not previously associated with UAV, whereas our study showed statistically significant correlation between MMP 3 and 4 and lowered UAV as measured radiographically. Yet, our findings are in partial opposition to the work of [PERSON] et al. who failed to confirm a direct relationship between BMI and the risk of OSA. Their MRI and CT study revealed that fats deposited around the upper airways, together with total soft tissues volume, indicate increased retroglossal and retropalatal collapsibility. However, this finding turned out to be valid for both patients with OSA and the control group [26]. This may be due to differences in body composition of the patients included in their study, e.g., people with an increased percentage of lean mass--athletes have higher BMI scores, which does not reflect the amount of body fat or indicate an increased risk of OSA. It should therefore be considered  
Figure 5: Significantly higher BMI scores (26.14 \(\pm\) 4.03 vs. 23.75 \(\pm\) 3.87) were observed in declared snorers (a) in comparison to non-snoring patients (b and c). \begin{table}
\begin{tabular}{c c c c} \hline \hline
**Parameter** & **Males** & **Females** & \(p\) \\ \hline Age & 45.37 \(\pm\) 17.41 & 43.78 \(\pm\) 12.89 & \textgreater{}0.05 \\ BMI & 26.08 \(\pm\) 3.43 & 24.58 \(\pm\) 4.27 & \textgreater{}0.05 \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Multifactorial logistic regression analysis. whether future studies would benefit from the use of the WHR (waist-hip ratio) instead of the BMI index [27]. [PERSON] et al. were the first to evaluate the reliability of the upper pharyngeal airway using CBCT in 10 patients, concluding that CBCT might be a valid and reliable tool to evaluate upper airway dimensions in the future [28]. [PERSON] et al. evaluated 3D characteristics of UAV and craniofacial volumetric structures in OSA adult patients [29]. The control group included healthy adults with no sleep disorders, according to Epworth sleepiness scale and the Berlin questionnaires. The data obtained from this investigation are consistent with our results--the mean value of UAV in the OSA group was smaller than in the control group, while the post-hyoid volume, posterior volume, and their ratio over total volume were larger than in the control group. The anatomical dimensions of the upper respiratory tract in correlation to the prevalence of sleep apnea were examined by [PERSON] et al. [30]. In their study, the measurements were based on CBCT and MRI imaging, including soft palate thickness, distance from the mandible plane to the hyoid bone, posterior airway space, and tongue volume. The study showed significantly longer mandibular-hyoid distance, smaller posterior airway space, and larger tongue volume in OSA patients compared to the control group (non-OSA patients). Their results are consistent with the present findings. With regard to the differences in the UAV, our findings also coincide with those observed by [PERSON] et al. [31] who used CBCT data to measure UAV in OSA patients. They found that OSA patients had a lower UAV in relation to healthy individuals.