Craniofacial morphology linked to childhood sleep-disordered breathing

By Lucy Piper, Senior medwireNews Reporter

Children with abnormal craniofacial morphology are at increased risk for having sleep-disordered breathing, say researchers.

The abnormalities include cross bite, a convex facial profile, hypertrophic tonsils, and increased lower facial height.

The team also found, however, that, unlike in adults, SDB was not significantly associated with excess weight in children.

This suggests that "there may be two different phenotypes of adult SDB: one related to excess fat tissue and the other to craniofacial abnormalities," note the researchers. Identification of those with the latter type in childhood could therefore mean prevention of the condition in some individuals by focusing on orthodontic treatment, they add.

The Finnish study included 491 children aged 6 to 8 years, 9.9% of whom had SDB.

Although 11.4% of boys and 15.6% of girls were classified as being overweight or obese according to International Obesity Task Force criteria, the prevalence of overweight and obesity were similar in children with and without OSD, at 13.0 and 13.4%, respectively.

The prevalence of abnormal craniofacial morphology was increased in children with SDB, however. Risk for SDB was 3.3 times higher in children with cross bite compared with those without, 2.6 times higher in children with a convex facial profile compared with a normal facial profile, and 3.7 times higher in children with tonsillar hypertrophy compared with those with normal size tonsils.

This was after adjustment for age, gender, and body fat percentage, the researchers report in the European Journal of Pediatrics.

Tiina Ikävalko, from Kupio University Hospital in Finland, and colleagues say: "Children with tonsillar hypertrophy, cross bite and convex facial profile could be candidates for early intervention and orthodontic treatment to prevent the progression of SDB in coming years.

"This can only happen via better understanding and earlier recognition of underlying mechanisms of SDB and an intensive collaboration between different medical specialties."

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