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Published on: December 6, 2016
Comprehensive analysis of orofacial motor skills in children with obstructive sleep apnea
Franciele Voltarelli da Silva Dias1,2, Luciana Vitaliano Voi Trawitzki1,2, Denny Marcos Garcia2
1Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery School of Medicine of Ribeirão Preto, University of São Paulo - USP, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.
Insights
Children with obstructive sleep apnea (OSA) exhibit weaker orofacial muscles and impaired motor skills. These findings highlight non-anatomical factors contributing to OSA and inform potential therapeutic strategies.
Area of Science:
- Pediatric Pulmonology
- Orofacial Myology
- Neuromuscular Physiology
Background:
- Neuromuscular activity significantly influences upper airway permeability.
- Obstructive sleep apnea (OSA) in children is a growing concern with complex contributing factors.
Purpose of the Study:
- To comparatively investigate orofacial musculature and motor skills in children with and without OSA.
- To identify potential non-anatomical factors associated with pediatric OSA.
Main Methods:
- Assessed orofacial appearance, posture, and motor skills using a standardized protocol in children aged 7-12.
- Measured bite force, tongue pressure, and surface electromyography during swallowing in OSA and control groups.
Main Results:
- Children with OSA demonstrated significantly lower scores in orofacial appearance, posture, mobility, and function compared to controls.
- Reduced bite force, tongue strength, and impaired swallowing dynamics (speed, peak activity, energy expenditure) were observed in the OSA group.
- Effect sizes for group differences ranged from moderate to large, indicating significant clinical relevance.
Conclusions:
- Pediatric OSA is associated with demonstrable impairments in orofacial muscle function and motor skills.
- Findings suggest reduced muscle recruitment capacity and coordination in children with OSA.
- This research aids in understanding OSA's non-anatomical contributors and developing targeted interventions.
Background:
The neuromuscular activity has a critical role in the permeability of the upper airways.
Objective:
The present study aimed to conduct a detailed and comparative investigation of the orofacial musculature and motor skills of children with obstructive sleep apnea (OSA).
Materials And Methods:
Children aged 7 to 12 years with OSA (OSA group, n = 12) and without OSA (Control group, n = 12) were compared. Orofacial appearance/posture and motor skills were assessed using the orofacial myofunctional evaluation protocol with scores. Bite force, tongue pressure measurements, and surface electromyography of swallowing were also performed.
Results:
Compared to the control group, the OSA group obtained lower scores in appearance/posture, mobility, and orofacial functions (P < 0.0001), and lower values of bite force (P = 0.019) and tongue strength in protrusion (P = 0.008) and deglutition (P = 0.004). The OSA group also displayed lower values of maximum speed (P = 0.003) and peak activity (P = 0.0005) during spontaneous swallowing and higher relative energy expenditure (integral) of the muscles in the water swallowing task (50 mL) (P ≤ 0.01). Notably, the effect size ranged from moderate to large for all groups differences.
Conclusion:
The children with OSA showed impairments in orofacial musculature and motor skills, as evidenced by reduced muscle recruitment capacity and coordination in applying pressure/force and performing orofacial movements and functions.
Clinical Relevance:
This study contributes to the understanding of non-anatomical factors associated with OSA in children and to the development of therapeutic strategies.
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