Faculty of Odonto-Stomatology, Hue University of Medicine and Pharmacy, Hue University, 49120 Hue, Vietna.
Institute of Dentistry, Faculty of Medicine, University of Tartu, 50090 Tartu, Estonia.
J Clin Pediatr Dent. 2023 Jul;47(4):25-34. doi: 10.22514/jocpd.2023.032. Epub 2023 Jul 3.
Orofacial myofunctional disorders (OMD) and sleep-disordered breathing (SDB) may present as comorbidities. Orofacial characteristics might serve as a clinical marker of SDB, allowing early identification and management of OMD and improving treatment outcomes for sleep disorders. The study aims to characterize OMD in children with SDB symptoms and to investigate possible relationships between the presence of various components of OMD and symptoms of SDB. A cross-sectional study of healthy children aged 6-8 from primary schools was conducted in central Vietnam in 2019. SDB symptoms were collected using the parental Pediatric Sleep Questionnaire, Snoring Severity Scale, Epworth Daytime Sleepiness Scale, and lip-taping nasal breathing assessment. Orofacial myofunctional evaluation included assessment of tongue mobility, as well as of lip and tongue strength using the Iowa Oral Performance Instrument, and of orofacial characteristics by the protocol of Orofacial Myofunctional Evaluation with Scores. Statistical analysis was used to investigate the relationship between OMD components and SDB symptoms. 487 healthy children were evaluated, of whom 46.2% were female. There were 7.6% of children at high risk of SDB. Children with habitual snoring (10.3%) had an increased incidence of restricted tongue mobility and decreased lip and tongue strength. Abnormal breathing patterns (22.4%) demonstrated lower posterior tongue mobility and lower muscle strength. Daytime sleepiness symptoms were associated with changes in muscle strength, facial appearance, and impaired orofacial function. Lower strengths of lip and tongue or improper nasal breathing were more likely to be present in children with reported sleep apnea (6.6%). Neurobehavioral symptoms of inattention and hyperactivity were linked to anomalous appearance/posture, increases in tongue mobility and oral strength. This study demonstrates a prevalence of orofacial myofunctional anomalies in children exhibiting SDB symptoms. Children with prominent SDB symptoms should be considered as candidates for further orofacial myofunctional assessment.
口面肌功能紊乱（OMD）和睡眠呼吸障碍（SDB）可能同时存在。口面特征可作为 SDB 的临床标志物，有助于早期识别和管理 OMD，并改善睡眠障碍的治疗效果。本研究旨在分析 SDB 症状患儿的 OMD 特征，并探讨 OMD 各组成部分与 SDB 症状之间的可能关系。2019 年，在越南中部的一所小学中，进行了一项针对 6-8 岁健康儿童的横断面研究。采用父母用小儿睡眠问卷、打鼾严重程度量表、Epworth 白天嗜睡量表和唇贴鼻呼吸评估来收集 SDB 症状。口面肌功能评估包括舌运动能力评估、使用爱荷华口腔功能评估仪评估唇舌力量，以及使用口面肌功能评估评分方案评估口面特征。采用统计学分析方法来研究 OMD 组成部分与 SDB 症状之间的关系。共评估了 487 名健康儿童，其中 46.2%为女性。有 7.6%的儿童有 SDB 的高风险。习惯性打鼾的儿童（10.3%）其舌运动受限的发生率更高，唇舌力量下降。异常呼吸模式（22.4%）表现为舌后部下移，肌肉力量降低。日间嗜睡症状与肌肉力量、面部外观和口面功能障碍变化有关。报告有睡眠呼吸暂停的儿童（6.6%）更容易出现唇舌力量较弱或鼻呼吸不当。注意力不集中和多动的神经行为症状与异常的外观/姿势、舌运动增加和口腔力量增加有关。本研究表明，有 SDB 症状的儿童存在口面肌功能异常。具有明显 SDB 症状的儿童应被视为进一步口面肌功能评估的候选者。
