Does orthognathic surgery affect sleep quality? Evaluation of the effects of orthognathic surgery on subjective and objective OSA parameters in skeletal class III patients.

Abstract

This study aimed to assess the impact of orthognathic surgery on both subjective and objective obstructive sleep apnea (OSA) parameters and sleep quality in patients with skeletal class III. An upper airway evaluation was conducted using cone-beam computed tomography. Sleep quality was evaluated subjectively and objectively using the screening OSA questionnaires, the Functional Outcomes of Sleep Questionnaire, and sleep study testing. Data were collected from 23 patients at three time points: within 1 month before surgery (T0), within 1 month after surgery (T1), and 6 months after surgery (T2). Overall, there was a significant decrease in airway volume and minimal cross-sectional area at T1 and T2. Although there was partial recovery of these parameters at T2, they were not fully restored. No changes in subjective parameters were observed. Objective parameters showed significant increases in total apnea-hypopnea index (AHI) and obstructive AHI (ObsAHI) at T1. However, by T2, these values had decreased and were not significantly different from T0. Multivariable linear regression analysis found no associated variables for the change in ObsAHI. These findings suggest that while orthognathic surgery may initially impact upper airway morphology and objective sleep quality, some recovery and adaptation occur over time, though not to pre-surgery levels.