Prevalence of Altered Craniofacial Morphology in Children With OSA

Snoring and obstructive sleep apnoea (OSA) affect a significant percentage of children. Recent studies have suggested that altered craniofacial morphology may contribute to the multifactorial pathophysiology of OSA. This study aims to determine the prevalence of craniofacial abnormalities and malocclusion in children referred for polysomnography due to OSA suspicion. This is a multicentre prevalence study completed across four Canadian sites. Otherwise, healthy children (≥ 4 years old) who were seen at the sleep clinic were recruited. Upon arrival for their hospital-based overnight sleep recording, a clinical orthodontic assessment and a series of paediatric sleep questionnaires were completed for each participant. Data from 315 children (age 9.37 ± 3.70) revealed significant risk factors associated with the presence of OSA, including male sex, presence of snoring, endomorph body type, and hypertrophic tonsils. The intra-oral and facial morphologic characteristics were not significantly different between children with (AHI 9.51 ± 10.94) and without (AHI 0.84 ± 0.50) PSG-verified OSA. Factors such as maxillary constriction/posterior crossbite and a retrognathic mandible showed similar (p > 0.05) prevalence between groups. Hierarchical regression analysis showed no statistically significant facial and dental variables in predicting AHI. In conclusion, a multidisciplinary approach involving dental professionals with expertise in growth and development is crucial for the assessment of possible craniofacial abnormalities in children with OSA. Craniofacial morphology may play a limited role in the pathophysiology of OSA in most children, as no differences in the prevalence of these variables in children with and without OSA were found in this large, multicentre study.