Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery School of Medicine of Ribeirão Preto, University of São Paulo - USP, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.
Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil.
Sleep Breath. 2024 Nov 26;29(1):8. doi: 10.1007/s11325-024-03178-y.
The neuromuscular activity has a critical role in the permeability of the upper airways.
The present study aimed to conduct a detailed and comparative investigation of the orofacial musculature and motor skills of children with obstructive sleep apnea (OSA).
Children aged 7 to 12 years with OSA (OSA group, n = 12) and without OSA (Control group, n = 12) were compared. Orofacial appearance/posture and motor skills were assessed using the orofacial myofunctional evaluation protocol with scores. Bite force, tongue pressure measurements, and surface electromyography of swallowing were also performed.
Compared to the control group, the OSA group obtained lower scores in appearance/posture, mobility, and orofacial functions (P < 0.0001), and lower values of bite force (P = 0.019) and tongue strength in protrusion (P = 0.008) and deglutition (P = 0.004). The OSA group also displayed lower values of maximum speed (P = 0.003) and peak activity (P = 0.0005) during spontaneous swallowing and higher relative energy expenditure (integral) of the muscles in the water swallowing task (50 mL) (P ≤ 0.01). Notably, the effect size ranged from moderate to large for all groups differences.
The children with OSA showed impairments in orofacial musculature and motor skills, as evidenced by reduced muscle recruitment capacity and coordination in applying pressure/force and performing orofacial movements and functions.
This study contributes to the understanding of non-anatomical factors associated with OSA in children and to the development of therapeutic strategies.
神经肌肉活动在上气道的通透性中起着关键作用。
本研究旨在对阻塞性睡眠呼吸暂停（OSA）儿童的口面肌肉和运动技能进行详细的对比研究。
比较了 7 至 12 岁患有 OSA（OSA 组，n=12）和无 OSA（对照组，n=12）的儿童。使用口面肌功能评估方案对口面外观/姿势和运动技能进行评估，并进行评分。还进行了咬合力、舌压测量和吞咽表面肌电图检查。
与对照组相比，OSA 组在外观/姿势、移动性和口面功能方面的评分较低（P<0.0001），且咬合力（P=0.019）和舌突出时的舌压强度（P=0.008）和吞咽时的舌压强度（P=0.004）均较低。OSA 组在自发吞咽时的最大速度（P=0.003）和峰值活动（P=0.0005）值较低，在水吞咽任务（50 毫升）中肌肉的相对能量消耗（积分）较高（P≤0.01）。值得注意的是，所有组间差异的效应量均为中到大。
患有 OSA 的儿童口面肌肉和运动技能受损，表现为肌肉募集能力降低，在施加压力/力量以及进行口面运动和功能时协调能力降低。
本研究有助于了解与儿童 OSA 相关的非解剖学因素，并为治疗策略的发展提供依据。
