title: Childhood obstructive sleep apnea syndrome: an interdisciplinary approach: a prospective epidemiological study of 4,318 five-and-a-half-year-old children.
abstract: Population-representative data on sleep disorders in children is scarce.
  
  
  OBJECTIVE
  The aim of this epidemiological study was to determine the prevalence of various sleep-related breathing disorders (SRBD) and any correlations with occlusion and jaw abnormalities in preschool children.
  
  
  METHODS
  The study material consisted of 4,318 children (5.5 years old) whose parents completed the Pediatric Sleep Questionnaire (PSQ); 60 out of 140 children (6.3 ± 0.78 years old) with a positive questionnaire score (> 0.33) were examined by an orthodontist and ENT specialist. From this cohort, 15 children who presented a dental occlusion and jaw abnormality but no indication for surgical reduction of adenotonsillar tissue underwent polysomnography in a sleep laboratory.
  
  
  RESULTS
  According to the PSQ, 3.3% of the 5.5-year-olds showed evidence of a SRBD. Boys were affected significantly more frequently. Lack of concentration, hyperactivity, morning fatigue, mouth breathing, loud snoring, and breathing interruptions were indicators of SRBD. The SRBD children more frequently presented with jaw abnormalities such as mandibular retrognathia, lateral cross-bite, and increased overjet. The SRBD cohort showed a higher rate of orofacial dysfunctions. Adenotonsillar hyperplasia still played a significant role in the development of SRBD.
  
  
  CONCLUSIONS
  In contrast to previous reports in the literature, the frequency of SRBD in our group of 5- to 6-year-olds was lower (3%). Boys with adenotonsillar hyperplasia and/or mandibular retrognathia, lateral cross bite, and an enlarged overjet require special attention.
authors.affiliation: Department of Orthodontics, Health Faculty, University of Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany. Constanze.Sauer@uni-wh.de
authors.forename: Constanze
authors.initials: C
authors.lastname: Sauer
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schlüter
authors.forename: Rolf
authors.initials: R
authors.lastname: Hinz
authors.forename: Dietmar
authors.initials: D
authors.lastname: Gesch
mesh_terms: D015984:Causality; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D058025:Interdisciplinary Studies; D007569:Jaw Abnormalities / Q000453:epidemiology*; D008297:Male; D008310:Malocclusion / Q000453:epidemiology*; D017286:Polysomnography / Q000706:statistics & numerical data*; D018570:Risk Assessment; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires