title: Impact of orthodontic appliances on sleep quality.
abstract: BACKGROUND
  Many young patients are asked to wear headgear or functional appliances during sleep as part of their orthodontic treatment. The objective of this clinical study was to assess the impact of these appliances on sleep quality.
  
  
  METHODS
  Twenty-two subjects (8 boys, 14 girls) between 10 and 15 years of age wearing either a headgear or a removable appliance for 3 to 12 months were enrolled in a sleep study. Each subject participated in 2 overnight sleep studies with and without the appliance. There was a 1-week interval after an adaptation night. The studies were performed at the Sleep Research Laboratory at Toronto Western Hospital in Canada. Each subject served as his or her own control. Twelve subjects had an extraoral headgear appliance, and 10 had intraoral functional (5 Fränkel, 5 Twin-block) appliances. No subject reported any sleep or medical disorder. The primary outcome variable was sleep efficiency.
  
  
  RESULTS
  Sleep efficiencies were 90.7% (SD, 7.9) and 91.6% (SD, 4.3) with and without the appliances, respectively. When sleep quality was compared with and without appliances, analysis of variance (ANOVA) showed no significant difference in sleep efficiency or other sleep variables such as sleep onset latency, rapid eye movement onset latency, rapid eye movement percentage, short-wave sleep percentage, or respiratory disturbance index. Sex and body mass index were not confounding variables. In addition, the use of extraoral or intraoral appliances did not affect sleep quality.
  
  
  CONCLUSIONS
  In young orthodontic patients, there appears to be no difference in sleep quality with or without the overnight use of these appliances after they have been worn for a minimum of 3 months.
authors.affiliation: Bowmanville and Oshawa, Ontario, Canada. a.rawji@utoronto.ca
authors.forename: Akbar
authors.initials: A
authors.lastname: Rawji
authors.forename: Larry
authors.initials: L
authors.lastname: Parker
authors.forename: Prativa
authors.initials: P
authors.lastname: Deb
authors.forename: Donald
authors.initials: D
authors.lastname: Woodside
authors.forename: Bryan
authors.initials: B
authors.lastname: Tompson
authors.forename: Colin M
authors.initials: CM
authors.lastname: Shapiro
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006185:Habituation, Psychophysiologic; D006801:Humans; D008297:Male; D016382:Orthodontic Appliance Design; D009968:Orthodontic Appliances, Removable / Q000009:adverse effects*; D009971:Orthodontics, Corrective / Q000295:instrumentation*; D010349:Patient Compliance; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000209:etiology*; D013997:Time Factors