Faculté de Médecine Dentaire, Université de Montréal, Montréal, Québec, Canada.
Am J Orthod Dentofacial Orthop. 2011 Dec;140(6):762-70. doi: 10.1016/j.ajodo.2011.03.023.
Chronic snoring is considered abnormal in a pediatric population. This disorder is often attributed to enlarged tonsils and adenoids, but multiple anatomic obstructions should also be considered. Facial and dental morphometry associations with various sleep-disordered breathing symptoms were investigated at an orthodontic clinic.
Parents or guardians were asked to complete a 4-part questionnaire on behalf of their children (n = 604; <18 years of age), including medical and dental history, bruxism and temporomandibular disorder habits, sleep and daytime behavior, and sleep duration and quality. All subjects underwent a clinical screening assessment by the same orthodontist to identify standard dental, skeletal, functional, and esthetic factors.
In contrast to sleep-disordered breathing or sleep apnea in adults, which is predominantly associated with obesity, sleep-disordered breathing symptoms in this pediatric cohort were primarily associated with adenotonsillar hypertrophy, morphologic features related to a long and narrow face (dolichofacial, high mandibular plane angle, narrow palate, and severe crowding in the maxilla and the mandible), allergies, frequent colds, and habitual mouth breathing.
Because of the recognized impact of pediatric snoring on children's health, the determination of these good predictors can help in preventing and managing sleep-disordered breathing. If a health professional notices signs and symptoms of sleep-disordered breathing, the young patient should be referred to a sleep medicine specialist in conjunction with an orthodontist if there are dentoskeletal abnormalities.
在儿科人群中,慢性打鼾被认为是异常的。这种疾病通常归因于扁桃体和腺样体增大,但也应考虑多种解剖阻塞。在正畸诊所,研究了与各种睡眠呼吸障碍症状相关的面部和牙齿形态计量学。
父母或监护人代表其子女(n=604;<18 岁)填写了 4 部分问卷,包括医疗和牙科史、磨牙症和颞下颌关节紊乱习惯、睡眠和白天行为以及睡眠持续时间和质量。所有受试者均由同一位正畸医生进行临床筛查评估,以确定标准的牙科、骨骼、功能和美学因素。
与成人中主要与肥胖相关的睡眠呼吸障碍或睡眠呼吸暂停不同,该儿科队列中的睡眠呼吸障碍症状主要与腺样体扁桃体肥大、与长而窄面相关的形态特征(长面型、下颌平面角高、腭狭窄以及上颌和下颌严重拥挤)、过敏、频繁感冒和习惯性口呼吸有关。
由于小儿打鼾对儿童健康的公认影响,确定这些良好的预测因子有助于预防和管理睡眠呼吸障碍。如果健康专业人员注意到睡眠呼吸障碍的迹象和症状,并且存在牙颌骨骼异常,则应将年轻患者转介给睡眠医学专家和正畸医生。