Rapid maxillary expansion and its impact on sleep apnea in children aged 5 to 8 years: a retrospective study

Determine the impact of early transverse maxillary expansion on the symptomatic manifestation of sleep apnea in children aged 5-8 years.

Nineteen patients (mean age: 6.84 years) with maxillary constriction underwent rapid maxillary expansion (RME) for orthodontic treatment. Inclusion criteria: age 5-8 years, Apnea-Hypopnea Index (AHI) > 1, treated with Memory screw Hyrax appliance, under pediatric sleep physician care. Exclusion criteria: non-compliance, re-evaluation delays (> 3 months). Primary variable: AHI before (T0) and after (T1) expansion. Treatment ended based on malocclusion correction. AHI comparisons included dentition status and gender as secondary variables.

A paired t-test showed no significant difference in the mean AHI between T0 (4.05±2.55) and T1 (3.68±3.12) for primary variables (p>0.05). At T0, no significant AHI difference was found between genders (F: 3.21±2.47; M: 4.09±2.87, p>0.05). After expansion (T1), a significant change was observed between genders (F: 1.75±1.03; M: 5.18±3.68, p<0.05). There was also no significant difference in AHI changes based on dentition status. A negative correlation was found between AHI changes and transverse changes and at canine and molar levels.

No significant evidence was found to support the effectiveness of early maxillary expansion in improving sleep apnea among children with maxillary constriction. However, the gender-specific responses and the potential dose-response relationship between maxillary expansion and AHI reduction highlight the complexity of treating pediatric OSA.