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Updated: Jan 13, 2026

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Association between mouth breathing and pediatric obstructive sleep apnea: a systematic review

Padmanabhan Vaishnavi1, Shan Sushmita1, K Vivek1

  • 1Department of Pediatric and Preventive Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamilnadu, India.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|January 12, 2026
PubMed

Insights

Mouth breathing is strongly linked to pediatric obstructive sleep apnea (P-OSA). Early identification of mouth breathing can aid in diagnosing and managing P-OSA, improving treatment outcomes.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Physiology
  • Craniofacial Development

Background:

  • Sleep is vital for children's development, but sleep disorders like obstructive sleep apnea (OSA) disrupt it.
  • Polysomnography, the gold standard for OSA diagnosis, has limited accessibility.
  • Mouth breathing is a visible indicator of P-OSA and can exacerbate OSA risk by affecting craniofacial growth.

Purpose of the Study:

  • To systematically review and synthesize evidence on the association between mouth breathing and pediatric obstructive sleep apnea (P-OSA).

Main Methods:

  • Systematic literature search using PEO framework across multiple databases (PubMed, EMBASE, Scopus, etc.) up to September 2025.
  • Included 13 studies (2 cross-sectional, 11 cohort) after rigorous screening and quality assessment.
  • Data analysis managed using Distiller SR software.

Main Results:

  • A significant correlation was found between mouth breathing and OSA severity in most studies.
  • Mouth breathing was identified as a potential predictor of persistent P-OSA post-adenotonsillectomy.
  • Variability in diagnostic methods across studies led to some inconsistent findings.

Conclusions:

  • Mouth breathing is closely associated with P-OSA, serving as a crucial marker for early diagnosis.
  • Recognizing mouth breathing is essential for assessing P-OSA and monitoring treatment effectiveness.
  • Healthcare providers should be vigilant in assessing mouth breathing as an early indicator of P-OSA.
Abstract

Keywords:
ChildrenCraniofacial developmentMouth breathingOral habitsPediatric obstructive sleep apneaSleep disordered breathing

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