Craniofacial changes and symptoms of sleep-disordered breathing in healthy children

Maria Christina Thomé Pacheco,Maria Teresa Martins De Araújo,Nathalia Silveira Finck,Bruna Santos Fiorott

doi:10.1590/2176-9451.20.3.080-087.oar

Maria Christina Thomé Pacheco, Maria Teresa Martins De Araújo + Show 2 more

Open Access

https://doi.org/10.1590/2176-9451.20.3.080-087.oar

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Abstract

INTRODUCTION: The main cause of mouth breathing and sleep-disordered breathing (SDB) in childhood is associated with upper airway narrowing to varying degrees. OBJECTIVE: The aim of this study was to assess the prevalence of morphological and functional craniofacial changes and the main clinical symptoms of SDB in healthy children. METHODS: A cross-sectional observational study was conducted. A sample comprising 687 healthy schoolchildren, aged 7-12 years old and attending public schools, was assessed by medical history, clinical medical and dental examination, and respiratory tests. The self-perceived quality of life of mouth breathing children was obtained by a validated questionnaire. RESULTS: Out of the total sample, 520 children were nose breathers (NB) while 167 (24.3%) were mouth breathers (MB); 32.5% had severe hypertrophy of the palatine tonsils, 18% had a Mallampati score of III or IV, 26.1% had excessive overjet and 17.7% had anterior open bite malocclusion. Among the MB, 53.9% had atresic palate, 35.9% had lip incompetence, 33.5% reported sleepiness during the day, 32.2% often sneezed, 32.2% had a stuffy nose, 19.6% snored, and 9.4% reported having the feeling to stop breathing while asleep. However, the self-perception of their quality of life was considered good. CONCLUSION: High prevalence of facial changes as well as signs and symptoms of mouth breathing were found among health children, requiring early diagnosis and treatment to reduce the risk of SDB.

Highlights

The main cause of mouth breathing and sleep-disordered breathing (SDB) in childhood is associated with upper airway narrowing to varying degrees
In contrast with SDB in adults, which is usually associated with obesity, the pediatric population experiences these disorders in association with hypertrophy of tonsils and adenoids, allergies, frequent colds and mouth breathing.[1,2,3,4,5,6,7]
Because mouth breathing is one of the predisposing factors to SDB in children, this study aims to assess the prevalence of the morphological and functional craniofacial changes and the main nasal and sleep symptoms reported by healthy schoolchildren aged between 7 and 12 years old

Summary

Introduction

The main cause of mouth breathing and sleep-disordered breathing (SDB) in childhood is associated with upper airway narrowing to varying degrees. Objective: The aim of this study was to assess the prevalence of morphological and functional craniofacial changes and the main clinical symptoms of SDB in healthy children. Conclusion: High prevalence of facial changes as well as signs and symptoms of mouth breathing were found among health children, requiring early diagnosis and treatment to reduce the risk of SDB. The association between mouth breathing and SDB has been described as a public health concern because of the clinical impact of these disorders on craniofacial development and growth, delay in height and weight growth and behavioral changes, such as hyperactivity, irritability, restless sleep, impaired concentration and reduced school performance.[8,9,10]. Anamnesis should tackle aspects of sleep pattern, especially in mouth-breathing children.[2,3,4,5]

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