Nathalie Nietvelt , Guy Willems , Bertien Buyse , Valentine Detailleur , Maria Cadenas de Llano-Pérula
{"title":"儿童睡眠呼吸障碍症状:上颌扩张后5年的前瞻性评价","authors":"Nathalie Nietvelt , Guy Willems , Bertien Buyse , Valentine Detailleur , Maria Cadenas de Llano-Pérula","doi":"10.1016/j.sleep.2025.106700","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of maxillary expansion and of different types of subsequent comprehensive orthodontic treatment on sleep disordered breathing (SDB) symptoms in children five years after maxillary expansion.</div></div><div><h3>Methods</h3><div>Children needing early maxillary expansion were asked to fill the Pediatric Sleep Questionnaire (PSQ) at three time points: before the start of maxillary expansion (T0; N = 404), after active expansion (T1; N = 309) and after the completion of comprehensive orthodontic treatment (T2; N = 113). Maxillary expansion was achieved using a removable expansion plate (80,49 %), a hyrax (18,03 %) or a quadhelix (1,48 %). When indicated, comprehensive orthodontic treatment either consisted of fixed appliances alone or was combined with a class II functional appliance, a headgear or a hyrax. Linear mixed models corrected for age were used to compare the PSQ results per time point.</div></div><div><h3>Results</h3><div>Significant reductions in the total PSQ scores (p < 0.0001), breathing (p < 0.0001), behavior (p = 0.0026) and loudness of snoring (p = 0.0107) were observed between T0 and T1, which maintained between T0 and T2 (p = 0.0275; p = 0.0281; p = 0.0243). Between T1 and T2 and T0 and T2, sleepiness significantly increased (p < 0.0001; p = 0.0004).</div><div>No significant interaction was found between the four different types of comprehensive orthodontic treatment and the PSQ scores.</div></div><div><h3>Conclusion</h3><div>Early maxillary expansion with removable plates has general a positive effect on PSQ scores. These improvements exhibit a stability for at least five years, regardless of the type of subsequent comprehensive orthodontic treatment. Therefore, the orthodontist plays an important role in the early detection and multidisciplinary treatment of pediatric obstructive sleep apnea syndrome.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"134 ","pages":"Article 106700"},"PeriodicalIF":3.4000,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sleep disordered breathing symptoms in children: a prospective evaluation 5 years after maxillary expansion\",\"authors\":\"Nathalie Nietvelt , Guy Willems , Bertien Buyse , Valentine Detailleur , Maria Cadenas de Llano-Pérula\",\"doi\":\"10.1016/j.sleep.2025.106700\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To investigate the effects of maxillary expansion and of different types of subsequent comprehensive orthodontic treatment on sleep disordered breathing (SDB) symptoms in children five years after maxillary expansion.</div></div><div><h3>Methods</h3><div>Children needing early maxillary expansion were asked to fill the Pediatric Sleep Questionnaire (PSQ) at three time points: before the start of maxillary expansion (T0; N = 404), after active expansion (T1; N = 309) and after the completion of comprehensive orthodontic treatment (T2; N = 113). Maxillary expansion was achieved using a removable expansion plate (80,49 %), a hyrax (18,03 %) or a quadhelix (1,48 %). When indicated, comprehensive orthodontic treatment either consisted of fixed appliances alone or was combined with a class II functional appliance, a headgear or a hyrax. Linear mixed models corrected for age were used to compare the PSQ results per time point.</div></div><div><h3>Results</h3><div>Significant reductions in the total PSQ scores (p < 0.0001), breathing (p < 0.0001), behavior (p = 0.0026) and loudness of snoring (p = 0.0107) were observed between T0 and T1, which maintained between T0 and T2 (p = 0.0275; p = 0.0281; p = 0.0243). Between T1 and T2 and T0 and T2, sleepiness significantly increased (p < 0.0001; p = 0.0004).</div><div>No significant interaction was found between the four different types of comprehensive orthodontic treatment and the PSQ scores.</div></div><div><h3>Conclusion</h3><div>Early maxillary expansion with removable plates has general a positive effect on PSQ scores. These improvements exhibit a stability for at least five years, regardless of the type of subsequent comprehensive orthodontic treatment. Therefore, the orthodontist plays an important role in the early detection and multidisciplinary treatment of pediatric obstructive sleep apnea syndrome.</div></div>\",\"PeriodicalId\":21874,\"journal\":{\"name\":\"Sleep medicine\",\"volume\":\"134 \",\"pages\":\"Article 106700\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-07-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1389945725003752\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1389945725003752","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Sleep disordered breathing symptoms in children: a prospective evaluation 5 years after maxillary expansion
Objective
To investigate the effects of maxillary expansion and of different types of subsequent comprehensive orthodontic treatment on sleep disordered breathing (SDB) symptoms in children five years after maxillary expansion.
Methods
Children needing early maxillary expansion were asked to fill the Pediatric Sleep Questionnaire (PSQ) at three time points: before the start of maxillary expansion (T0; N = 404), after active expansion (T1; N = 309) and after the completion of comprehensive orthodontic treatment (T2; N = 113). Maxillary expansion was achieved using a removable expansion plate (80,49 %), a hyrax (18,03 %) or a quadhelix (1,48 %). When indicated, comprehensive orthodontic treatment either consisted of fixed appliances alone or was combined with a class II functional appliance, a headgear or a hyrax. Linear mixed models corrected for age were used to compare the PSQ results per time point.
Results
Significant reductions in the total PSQ scores (p < 0.0001), breathing (p < 0.0001), behavior (p = 0.0026) and loudness of snoring (p = 0.0107) were observed between T0 and T1, which maintained between T0 and T2 (p = 0.0275; p = 0.0281; p = 0.0243). Between T1 and T2 and T0 and T2, sleepiness significantly increased (p < 0.0001; p = 0.0004).
No significant interaction was found between the four different types of comprehensive orthodontic treatment and the PSQ scores.
Conclusion
Early maxillary expansion with removable plates has general a positive effect on PSQ scores. These improvements exhibit a stability for at least five years, regardless of the type of subsequent comprehensive orthodontic treatment. Therefore, the orthodontist plays an important role in the early detection and multidisciplinary treatment of pediatric obstructive sleep apnea syndrome.
期刊介绍:
Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without.
A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry.
The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.