NREM sleep instability changes following rapid maxillary expansion in children with obstructive apnea sleep syndrome

Miano, Silvia; Rizzoli, Alessandra; Evangelisti, Melania; Bruni, Oliviero; Ferri, Raffaele; Pagani, Jacopo; Villa, Maria Pia

doi:10.1016/j.sleep.2008.04.003

Cited by 50 publications

(48 citation statements)

References 47 publications

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“…Unfortunately, we did not compare sleep architecture parameters with those of a control group, in order to better understand such discrepancies. We cannot establish whether these differences are influenced by aging, or are an indirect sign of incomplete recovery from OSAS, as we reported in a previous investigation on sleep architecture and arousals in the same group of children treated with RME [22].…”

Section: Discussionmentioning

confidence: 67%

Efficacy of rapid maxillary expansion in children with obstructive sleep apnea syndrome: 36 months of follow-up

et al. 2011

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Section: Discussionmentioning

confidence: 67%

Efficacy of rapid maxillary expansion in children with obstructive sleep apnea syndrome: 36 months of follow-up

et al. 2011

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“…Associated with the occurrence of abnormal nocturnal respiratory events are sleep fragmentations caused by repetitive arousals and sleep instability due to reduction in the amount of slow-wave activity (23). In children, the beneficial effects of the orthodontic expansion treatment of the maxilla include both normalisation of sleep architecture and improvement of SDB (11,(21)(22)(23). However, in adults, the effects of the treatment on sleep and nocturnal respiration are far less known.…”

Section: Discussionmentioning

confidence: 99%

“…The third cycle had significant interaction between treatment and period (P = 0Á018). Overall, for high beta activity (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32), there was a significant interaction between treatment, cycle and period (P < 0Á001). The third cycle had significant interaction between treatment and period (P = 0Á025).…”

Section: Sleep Microstructurementioning

confidence: 99%

The effect of surgically assisted rapid maxillary expansion on sleep architecture: an exploratory risk study in healthy young adults

Bach

Tuomilehto

Gauthier

et al. 2013

J of Oral Rehabilitation

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Maxillary transverse deficiencies (MTD) cause malocclusions. Rapid maxillary expansion treatment is commonly used treatment for correcting such deficiencies and has been found to be effective in improving respiration and sleep architecture in children with obstructive sleep apnoea (OSA). However, thus far, the effect of surgically assisted rapid maxillary expansion (SARME) treatment on sleep architecture and breathing of normal subjects has not been assessed. We hypothesised that sleep quality will improve after maxillary expansion treatment. The objective of this study is to access the effect of maxillary expansion treatment on sleep structure and respiratory functions in healthy young adults with severe MTD. This is a prospective and exploratory clinical study. Twenty-eight consecutive young adult patients (15 males and 13 females, mean age 20·6 ± 5·8 years) presenting with severe MTD at the orthodontic examination were recruited into the study. All the participants underwent a standardised SARME procedure (mean expansion 6·5 ± 1·8 and 8·2 ± 1·8 mm, intercanine and intermolar distance, respectively) to correct malocclusion caused by MTD. An overnight in-laboratory polysomnography, before and after the treatment, was performed. The mean follow-up time was 9 months. The main outcome parameters were the changes in sleep architecture, including sleep stages, arousals, slow-wave activity (SWA) and respiratory variables. Before surgery, young adult patients with MTD presented no evidence of sleep breathing problems. At baseline sleep recording, 7 of 28 (25%) had apnoea-hypopnoea index (AHI) ≥ 5 events per hour. No negative effect of the SARME was observed in questionnaires or sleep laboratory parameters. In the patients with a higher baseline AHI (AHI ≥ 5 h of sleep), we observed a reduction in AHI after surgical treatment (P = 0·028). SARME did not have a negative effect on any sleep or respiration parameters in healthy young individuals with MTD. It normalised the breathing index in the patients with a mild AHI index.

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“…A1 phase frequency of CAP (a protective reaction of the sleeping brain) has been shown to be reduced in children with SDB92 and A2 phases (mild cortical activation) increased among children with OSAS compared with controls 93. A rebound in A1 indices was observed among children with OSAS 1 year after rapid maxillary expander treatment; however, other measures such as A2 frequency remained unchanged 94. The functional significance of these differences is yet to be determined as is the association with neurocognitive performance and behavior.…”

Section: Possible Mechanismsmentioning

confidence: 96%

Neurocognitive performance and behavior before and after treatment for sleep-disordered breathing in children

Köhler

Lushington²,

Kennedy³

2010

NSS

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Neurocognitive and behavioral problems are increasingly reported in children with sleep-disordered breathing (SDB). The impact of treatment for SDB on neurocognition and behavior is, therefore, an issue of increasing importance. To date, there has been little consideration given to the quality of studies when reviewing associated neurocognitive and behavioral problems in children with SDB, and furthermore, there has been little systematic review of treatment outcomes. The aim of this review was to provide an up-to-date and critical review of the current literature. Findings indicate a specific pattern of neurocognitive problems in children with SDB; however, the pattern of behavioral problems is less clear. Very few studies were found to provide a rigorous investigation of posttreatment neurocognitive and behavior outcomes. Despite this, relatively consistent improvements in global intelligence, attention, and visual spatial ability are shown; however, persistent deficits in other domains are also evident. For behavior, problems of hyperactivity, aggression or conduct problems, and somatic complaints improve following treatment. In contrast, symptoms of anxiety and social problems less consistently improve. These findings should aid in the development of more targeted investigations and well-designed studies exploring both the causative mechanisms and the treatment response for neurocognitive and behavior problems in children with SDB.

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NREM sleep instability changes following rapid maxillary expansion in children with obstructive apnea sleep syndrome

Cited by 50 publications

References 47 publications

Efficacy of rapid maxillary expansion in children with obstructive sleep apnea syndrome: 36 months of follow-up

Efficacy of rapid maxillary expansion in children with obstructive sleep apnea syndrome: 36 months of follow-up

The effect of surgically assisted rapid maxillary expansion on sleep architecture: an exploratory risk study in healthy young adults

Neurocognitive performance and behavior before and after treatment for sleep-disordered breathing in children

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