Abstract
Study objectives: This study wanted to evaluate the correlations between haematic cortisol levels and the craniofacial morphology in children with Obstructive Sleep Apnoea Syndrome (OSAS) in comparison with healthy children. Measurements and results: Haematic cortisol concentration at 2.00 am was found higher in OSAS patients than in controls (p<0.05). An increase in craniomandibular (p<0.05) and intermaxillar (p<0.01) angles indicated a high angle tendency in OSAS with a posterior rotation of the mandible. A retro-position of the mandible (p<0.05), an increased overjet (p<0.01) and a reduction of overbite (p<0.01) were also found. Conclusions: The altered hypothalamic-pituitary-adrenal activity and the craniofacial modification found are not enough to state if these conditions are causes rather than consequences of OSAS. Moreover cortisol and sleep fragmentation can cause a reduction of growth hormone secretion so it is possible that the alteration of facial morphology may also have a metabolic cause.
Highlights
Obstructive Sleep Apnoea Syndrome (OSAS) is a common problem in children [1]
The altered hypothalamic-pituitary-adrenal activity and the craniofacial modification found are not enough to state if these conditions are causes rather than consequences of OSAS
Cortisol and sleep fragmentation can cause a reduction of growth hormone secretion so it is possible that the alteration of facial morphology may have a metabolic cause
Summary
Obstructive Sleep Apnoea Syndrome (OSAS) is a common problem in children [1]. A difference in the prevalence based on age is not proven, even if several studies indicate a peak of incidence between 2 and 8 years, which is the age in which the tonsils and adenoids are the largest in relation to the underlying airway [2]. Diagnosis of OSAS is based on medical history, physical examination and tests confirming the presence and severity of the upper airway obstruction, it is well known, that OSAS in children is associated with enlarged tonsils and adenoids, and with the presence of abnormal airway collapsibility during sleep [4]. Among the parameters measured with PSG, the Apnoea-Hypopnoea Index (AHI) is commonly used to evaluate the presence or absence of disease and to assess its severity; the AHI represents the number of obstructive apnoea and obstructive hypopne as observed per hour of Total Sleep Time (TST)
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