PURPOSE: To determine the prevalence of Sleep Disturbances (SD) in children and to evaluate the correlation between dental classification and airway dimensions. METHODS: Children between 3 – 18 years at the Boston University Pediatric Oral Healthcare Center in Boston, Massachusetts were recruited for this study. Based on parents’ responses in a brief sleep-screening questionnaire, cases were identified as children with SD and controls were those without. Another detailed questionnaire was used to collect information on demographics and sleep patterns. Clinical and upper airway examinations were conducted using Eccovision Acoustic Rhinometer (AR) and Acoustic Pharyngometer (AP). Statistical differences in upper airway measurements by type of dental occlusion were evaluated. RESULTS: Among 281 children, the prevalence of SD was 38%. Upper airway measurements among 176 participants using AP showed significantly higher pharyngeal Minimum Cross-Sectional Area (MCA) for class III dental occlusion compared to class I (P=.036) in children with SD. Statistically significant differences in MCA, Airway Volume (AV), and minimum distance to MCA by type of dental occlusion were mainly observed among children with SD (P<.05). CONCLUSIONS: The results highlight a possible correlation between nasal and pharyngeal airway dimensions and dental classification among children with SD. Further analysis that include radiological examinations may help in confirming these findings.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-08-04T14:36:35Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertacao FINAL - Paulo Vitorino.pdf: 2187063 bytes, checksum: c2fe1eb8fae33ac15ace546071154809 (MD5) / Made available in DSpace on 2017-08-04T14:36:35Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertacao FINAL - Paulo Vitorino.pdf: 2187063 bytes, checksum: c2fe1eb8fae33ac15ace546071154809 (MD5) Previous issue date: 2016-06-13 / A apneia obstrutiva do sono (AOS) é definida como a presença de episódios recorrentes de obstrução das vias aéreas superiores durante o sono e apresenta-se como uma cessação (apneia) ou redução (hipopneia) do fluxo aéreo, apesar da manutenção dos esforços inspiratórios. Sua patogênese ainda é desconhecida, sendo descrita como multifatorial. Como forma de avaliação alternativa à polissonografia (PSG), o uso da faringometria acústica como diagnóstico complementar da apneia obstrutiva do sono tem sido proposto.A faringometria acústica tem por função verificar a geometria da cavidade orofaríngea, apresentando-se como um exame potencialmente útil para localização de possíveis pontos de obstrução das vias aéreas superiores nos casos de apneia obstrutiva do sono. O presente estudo teve como objetivo avaliar as curvas faringométricas em pacientes com AOS e correlacionar a gravidade e sintomas da doença com estas variáveis faringométricas. Foram avaliados vinte pacientes submetidos à polissonografia, classificados em sujeitos sem e com OSA leve (grupo 1) e com OSA moderado e grave (grupo 2). Os sujeitos foram triados do Ambulatório de Pneumologia do Hospital Otávio de Freitas. Foram obtidas informações sobre sexo, idade, peso, escala de ronco de Stanford e da polissonografia. Posteriormente, foram submetidos à faringometria acústica. Para testar a normalidade e homogeneidade dos dados, foram utilizados os testes de Shapiro-Wilk e Levene, respectivamente. Para comparação entre os grupos, foi utilizado o teste de Mann-Whitney. Para verificar a correlação entre as variáveis, foi usado o coeficiente de correlação de Spearman. Os resultados estão mostrados em mediana (valor mínimo - valor máximo) e diferenças significantes foram assumidas quando p<0,05. Foram encontrados valores menores da área média faríngea [1,9cm² (1,3-4,4 cm²) vs. 2,8cm² (2,4-4,9 cm²)] e da área laríngea [2,2cm² (1,42,8 cm²) vs. 3,1cm² (1,1-4,6 cm²)] no grupo 2 quando comparados com o grupo 1, respectivamente. Na correlação entre o índice de apneia e hipopneia e a área média da faringe (r=-0,607) e volume faríngeo (r=-0,523) foram observadas correlações negativas moderadas. De acordo com os resultados do presente trabalho, a gravidade da AOS parece induzir alterações na geometria da faringe, mais especificamente promovendo redução na área média e no volume da faringe. / Obstructive sleep apnea (OSA) is defined as the presence of recurrent episodes of obstruction of the upper airway during sleep and is presented as a cessation (apnea) or reduction (hypopnea) of airflow, despite continued inspiratory effort. Its pathogenesis is still unknown, being described as multifactorial. As an alternative assessment to polysomnography (PSG), the use of acoustic pharyngometry as complementary diagnosis of obstructive sleep apnea has been proposto.A acoustic pharyngometry has the function to check the geometry of the oropharyngeal cavity, presenting itself as a potentially useful test for location of possible points of obstruction of the upper airway in cases of obstructive sleep apnea. This study aimed to compare the faringométricas curves in different rates of apnea / hypopnea and correlate the severity of OSA with faringométricas variables. We evaluated twenty patients undergoing polysomnography, classified into subjects without and with mild OSA (group 1) and with moderate and severe OSA (group 2). The subjects were screened from the Clinic of Pneumology Hospital Otavio de Freitas. Sex information was obtained, age, weight, snoring scale of Stanford and polysomnography. Subsequently they underwent acoustic pharyngometry. To test the normality and homogeneity of the data, the Shapiro-Wilk and Levene tests were used, respectively. To compare the groups, the Mann-Whitney test. To verify the correlation between the variables, we used the Spearman correlation coefficient. The results are mostradoas median (minimum - maximum) and significant differences were assumed when p <0.05. They found lower values of the mean pharyngeal area [1,9cm² (1.3 to 4.4 cm²) vs. 2,8cm² (2.4 to 4.9 cm²)] and Laryngeal area [2,2cm² (1.4-2.8 cm²) vs. 3,1cm² (1.1 to 4.6 cm²)] in group 2 compared to group 1, respectively. The correlation between the apnea-hypopnea index and the average area of the pharynx (r = -0.607) and pharyngeal volume (r = -0.523) moderate negative correlations were observed. According to the results of this study, its severity appear to induce changes in the geometry of the pharynx, more specifically promoting a reduction in the average size and the volume of the pharynx.