Sleep-disordered breathing (SDB) is a spectrum of sleep disorders, ranging from primary snoring as milder form to obstructive sleep apnea (OSA) as more severe form. Rapid maxillary expansion (RME) could be an effective treatment for children with a narrow maxilla and OSA.
The aim of this study was to analyze the changes and improvement of symptoms of SDB using semi-RME (SRME) in children with narrow maxilla and SDB symptoms. Subjects were 15 patients who have sleep disorder (AHI > 1) and narrow maxillary arch between the age of 7 - 9 years. Before the SRME was applied, all subjects underwent pediatric sleep questionnaires (PSQ), lateral cephalometry, and portable sleep monitoring before expansion (T0). All subjects were treated with SRME for 2 months as activation and next 3 months as retention phase. All subjects had undergone PSQ, lateral cephalometry, and portable sleep monitoring after expansion (T1). Adenoidal-nasopharyngeal ratio (ANR), upper airway width and hyoid bone position were measured with lateral cephalometry. The data before and after SRME were statistically analyzed with frequency analysis and Wilcoxon signed rank test. According to reported by PSQ, total PSQ scale was decreased significantly from 0.45 before expansion to 0.18 after expansion. Particularly, snoring, breathing, and inattention hyperactivity were significantly improved (p < 0.01). ANR significantly decreased from 0.63 before expansion to 0.51 after expansion. Among upper airway widths, only palatopharyngeal airway width was significantly increased after expansion. There was no statistically significant difference in hyoid bone position after expansion. From analysis of portable sleep monitoring, changes in sleep characteristics showed a statistically significant decrease in AHI and ODI, and the lowest oxygen desaturation was significantly increased after SRME. In conclusion, early diagnosis with questionnaires and portable sleep monitoring and treatment using SRME will help growth and development healthy in children with SDB.