Sleep-Disordered Breathing Is Associated with Reduced Mandibular Cortical Width in Children

Area of Science:

• Pediatric Sleep Medicine
• Orthodontics
• Bone Physiology

Background:

• Sleep-disordered breathing (SDB) is linked to reduced bone density in adults.
• The association between SDB and bone health in children remains under-investigated.
• Mandibular cortical width (MCW) serves as a proxy for skeletal bone density.

Purpose of the Study:

• To investigate if children at risk of SDB or diagnosed with obstructive sleep apnea (OSA) exhibit reduced mandibular cortical width (MCW).
• To explore the relationship between SDB severity and MCW in pediatric patients.

Main Methods:

• Two retrospective cross-sectional studies were conducted.
• Study 1: Compared MCW in 24 children with polysomnographically diagnosed OSA versus 72 controls.
• Study 2: Assessed MCW in 101 children screened for SDB using the Pediatric Sleep Questionnaire (PSQ). MCW was measured from panoramic radiographs.

Main Results:

• Children with OSA had significantly thinner MCW (3.5 ± 0.6 mm) compared to healthy controls (2.9 ± 0.6 mm; P = 0.002).
• Severe SDB associated with OSA showed a negative correlation with MCW (β = -0.290, P = 0.049).
• Higher PSQ scores negatively correlated with MCW (β = -0.391, P < 0.001).

Conclusions:

• Children with SDB, including OSA, demonstrate reduced mandibular cortical width.
• This reduction may reflect underlying alterations in bone homeostasis or reduced bone formation.
• MCW shows potential as an adjunctive diagnostic parameter for SDB in children.