Recent research indicates a direct link between oral-facial growth disorder and pediatric obstructive sleep apnea when it occurs in non-obese children.
A study by Yu-Shu Huang1 and Christian Guilleminault reviewed experimental data compiled from infant monkeys, each of which had nasal resistance induced throughout the experiment. The data supported early historical data in orthodontic literature, which indicated abnormal orofacial development, related to mouth breathing and nasal resistance.
The resulting orofacial hypotonia, or lack of muscle tone and strength, fosters the development of orofacial abnormalities, which then is a direct contributor to the development of abnormal breathing during sleep. This conclusion was made based on the analysis of prospective data supplied from two groups: premature infants, as well as children treated for a sleep breathing disorder.
This research also finds that the typical treatment, a tonsillectomy, for a sleep breathing disorder in children, is incomplete in providing a total resolution. The study determined that sleep breathing disorders develop progressively even in children who underwent a tonsillectomy, and that any oral-facial anatomy abnormalities also must be treated in order to completely resolve any obstructive sleep apnea (OSA).
A continuous interaction exists between oral-facial muscle tone, maxillary-mandibular growth and the development of sleep breathing disorders, which can include OSA. Consequently, orofacial myofunctional therapy (OMT) can treat the contributing causes of pediatric sleep apnea, when combined with orthodontics and eliminating soft tissue in the upper airway.
The American Academy of Otolaryngology estimates that approximately 12 percent of the nation’s children suffer from a sleep breathing disorder, which could range from a simple case of snoring to severe OSA.
This is vital when considering the potential ramifications of sleep apnea in children, which can mimic symptoms of ADHD in many cases and affect mood, behavior, and academic performance. Therefore, a tonsillectomy is not always the single, most certain treatment for a child with OSA. Instead, physicians and dentists should collaborate their efforts in combining treatments such as orthodontics and OMT, when treating OSA in children.
Huang, Y., Guilleminault, C., (2015). Academy of Orofacial Myofunctional Therapy. Retrieved from https://aomtinfo.org/portfolio-item/pediatric-obstructive-sleep-apnea-and-the-critical-role-of-oral-facial-growth-evidences.