title: Sleep-disordered breathing in orthodontic practice: Prevalence of snoring in children and morphological findings.
abstract: OBJECTIVE
  The purpose of this work was to evaluate the prevalence of snoring and its correlation with cranial and upper airway morphology in young individuals with orthodontic treatment need.
  
  
  METHODS
  Parents of 379 children were consecutively interviewed, using eight questions from a more comprehensive questionnaire about sleep behavior. A total of 100 patients (54 girls, 46 boys, average age 11.3 years) met the inclusion criteria. Based on the parents' interviews, the sample was divided into snorers (n = 53) and nonsnorers (n = 47). Using cephalograms obtained for initial orthodontic diagnostics, airway morphology was measured based on hyoid position and on the posterior airway space (PAS) dimensions at the maxillary, occlusal, and mandibular plane levels (PAS_NL, PAS_OCCL, PAS_ML). Mann-Whitney U testing, ANOVA, and Spearman's rank correlation coefficient were used for statistical analysis.
  
  
  RESULTS
  Snoring was reported by 53 % of parents for 63 % (n = 29) of the boys and 44 % (n = 24) of the girls. Significant morphological differences were noted between snorers and nonsnorers. PAS dimensions were significantly reduced in the snorers compared to the nonsnorers at all three anatomical levels tested, which remained statistically significant when adjusted for age and gender. No differences between the two groups emerged for hyoid position or any of the vertical cranial parameters. A significant correlation between sagittal maxillary position (SNA) and PAS_NL was noted, indicating that larger SNA values were mildly associated with larger sagittal PAS dimensions at the maxillary level.
  
  
  CONCLUSIONS
  This random sample of young patients with orthodontic treatment need was found to involve a high prevalence of parent-reported snoring. Characteristic features in cranial and upper airway morphology and thus differences between the snorers and nonsnorers were found.
authors.affiliation: Department of Orthodontics, University Hospital of Cologne, Kerpener Strasse 32, 50931, Cologne, Germany. isabelle.graf@uk-koeln.de.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Graf
authors.affiliation: Orthodontic Practice, Essen, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Schumann
authors.affiliation: Department of Orthodontics, University Hospital of Cologne, Kerpener Strasse 32, 50931, Cologne, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Neuschulz
authors.affiliation: Department of Operative Dentistry and Periodontology, University Hospital of Cologne, Cologne, Germany.
authors.forename: Karolin
authors.initials: K
authors.lastname: Höfer
authors.affiliation: Oral and Maxillofacial Surgery Practice, Hennef, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Ritter
authors.affiliation: Department of Orthodontics, University Hospital of Cologne, Kerpener Strasse 32, 50931, Cologne, Germany.
authors.forename: Bert
authors.initials: B
authors.lastname: Braumann
mesh_terms: D002648:Child; D000067576:Child Health / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D009971:Orthodontics, Corrective / Q000706:statistics & numerical data; D015995:Prevalence; D012137:Respiratory System / Q000473:pathology*; D012307:Risk Factors; D012886:Skull / Q000473:pathology*; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology
keywords: Cephalograms; Morphology; Posterior airway space; Sleep-disordered breathing; Snoring