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NREM sleep instability changes following rapid maxillary expansion in children with obstructive apnea sleep syndrome

Silvia Miano1, Alessandra Rizzoli, Melania Evangelisti

  • 1Department of Pediatric, University of Rome La Sapienza - SantAndrea Hospital, Via Grottarossa , Rome 00189, Italy.

Sleep Medicine
|August 30, 2008
PubMed

Insights

Rapid maxillary expander (RME) treatment improved sleep in children with obstructive sleep apnea syndrome (OSAS), but sleep microstructure did not fully recover. Further research is needed to understand persistent sleep disturbances.

Area of Science:

  • Pediatric Sleep Medicine
  • Orthodontics
  • Respiratory Medicine

Background:

  • Obstructive sleep apnea syndrome (OSAS) in children can disrupt sleep architecture.
  • Cyclic alternating pattern (CAP) analysis offers insights into NREM sleep microstructure.
  • Rapid maxillary expander (RME) is used to treat maxillofacial abnormalities that may contribute to OSAS.

Purpose of the Study:

  • To evaluate the impact of RME treatment on NREM sleep microstructure in children with OSAS.
  • To assess changes in cyclic alternating pattern (CAP) metrics before and after one year of RME therapy.
  • To compare sleep parameters in children with OSAS to age-matched controls.

Main Methods:

  • Nine children with OSAS (aged 4-8 years) and age-matched controls underwent polysomnography.
  • Children with OSAS were recorded at baseline and after one year of RME treatment.
  • Sleep microstructure was analyzed using cyclic alternating pattern (CAP) during NREM sleep.

Main Results:

  • RME treatment reduced the apnea-hypopnea index and stage shifts in children with OSAS.
  • Baseline OSAS group showed higher CAP rate and A2 index during slow-wave sleep compared to controls.
  • After RME, OSAS group exhibited increased CAP rate and A1 index during slow-wave sleep.

Conclusions:

  • RME treatment partially normalized sleep architecture and improved respiratory disturbances in children with OSAS.
  • Sleep microstructure and respiratory parameters did not fully recover after RME treatment.
  • Persistent CAP alterations suggest potential partial orthodontic treatment failure or sleep normalization attempts.
Abstract

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