title: Influence of the breathing pattern on the learning process: a systematic review of literature.
abstract: BACKGROUND
  Mouth breathing leads to negative consequences on quality of life, especially in school-age children.
  
  
  OBJECTIVE
  To determine whether the breathing pattern influences children's learning process.
  
  
  METHODS
  This systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) instructions, with no restrictions regarding the year of publication and language, created based on the clinical question formulation according to the Problem/Patient/Population, Intervention/Indicator, Comparison, Outcome (PICO) strategy: "Is the mouth-breathing child more likely to have learning disabilities when compared to nasal breathers?" in the SciELO, PubMed, LILACS, and Scopus electronic databases. Google Scholar was used to search the gray literature. The keywords "learning," "mouth breathing," and their equivalent terms in Portuguese were used in an integrated manner. The studies included in the review were observational, conducted with schoolchildren aged 7-11 years. Afterwards, the studies were evaluated regarding their methodological quality. The research was performed by two eligible reviewers.
  
  
  RESULTS
  A total of 357 records were obtained, of which 43 records were duplicate. After applying the eligibility criteria, ten articles were included in the research scope. Half of the studies used a control group and otorhinolaryngological assessment, whereas a minority used validated (20%) and sample calculation protocols (10%). The evaluation procedures were varied. Overall, 80% of the articles showed a higher incidence of learning disabilities among mouth breathers.
  
  
  CONCLUSIONS
  This systematic review has shown that mouth breathers are more likely to have learning difficulties than nasal breathers.
authors.affiliation: Department of Speech Therapy and Audiology, Universidade Federal de Sergipe (UFS), Campus Prof. Antônio Garcia Filho, Lagarto, SE, Brazil.
authors.forename: Genef Caroline Andrade
authors.initials: GC
authors.lastname: Ribeiro
authors.affiliation: Department of Speech Therapy and Audiology, Universidade Federal de Sergipe (UFS), Campus Prof. Antônio Garcia Filho, Lagarto, SE, Brazil.
authors.forename: Isadora Diniz
authors.initials: ID
authors.lastname: Dos Santos
authors.affiliation: Department of Speech Therapy and Audiology, Universidade Federal de Sergipe (UFS), Campus Prof. Antônio Garcia Filho, Lagarto, SE, Brazil.
authors.forename: Ana Claudia Nascimento
authors.initials: AC
authors.lastname: Santos
authors.affiliation: Department of Odontology, Universidade Federal de Sergipe (UFS), Campus Prof. Antônio Garcia Filho, Lagarto, SE, Brazil.
authors.forename: Luiz Renato
authors.initials: LR
authors.lastname: Paranhos
authors.affiliation: Department of Speech Therapy and Audiology, Universidade Federal de Sergipe (UFS), Campus Prof. Antônio Garcia Filho, Lagarto, SE, Brazil. Electronic address: carlacesar@globo.com.
authors.forename: Carla Patrícia Hernandez Alves Ribeiro
authors.initials: CP
authors.lastname: César
mesh_terms: D006801:Humans; D007859:Learning Disabilities / Q000209:etiology* / Q000523:psychology; D009058:Mouth Breathing / Q000150:complications* / Q000523:psychology; D011788:Quality of Life
keywords: Aprendizagem; Escrita; Learning; Leitura; Matemática; Mathematics; Mouth breathing; Reading; Respiração bucal; Writing
references.citation: J Pediatr (Rio J). 2008 Mar-Apr;84(2):123-9
references.pmid: 18350229
references.citation: Braz J Otorhinolaryngol. 2013 Sep-Oct;79(5):620-4
references.pmid: 24141679
references.citation: J Dent. 2015 Mar;43(3):297-308
references.pmid: 25572792
references.citation: Sao Paulo Med J. 2015 Mar-Apr;133(2):78-83
references.pmid: 25271880
references.citation: Chest. 2003 Jul;124(1):196-203
references.pmid: 12853523
references.citation: Braz J Otorhinolaryngol. 2012 Jun;78(3):91-7
references.pmid: 22714853
references.citation: Int J Surg. 2010;8(5):336-41
references.pmid: 20171303