The relationship of pediatric obstructive sleep apnea with head and neck posture, hyoid bone position and airway dimensions.

OBJECTIVE

This cross-sectional study aimed to compare head and neck posture, hyoid bone position, and nasal and pharyngeal airway dimensions between orthodontic patients diagnosed with pediatric obstructive sleep apnea (OSA) and those with no risk of OSA.

MATERIALS AND

METHODS

OSA group included 35 individuals (mean age = 12 ± 2.1 years; 16 female, 19 male) with an apnea-hypopnea index (AHI) greater than 1 confirmed via polysomnography (AHI = 6.3 ± 6.0). The control group included 35 age- and gender-matched individuals with no OSA risk as determined by a score of '0' on the Pediatric Sleep Questionnaire. Measured parameters included head and neck posture angles-cranio-cervical (SN-CVT°, SN-OPT°), cranio-vertical (SN-VER°, NL-VER°, ML-VER°), and cervico-vertical (OPT-VER°, CVT-VER°); hyoid bone position measurements-H-Mp, H-C3, H-Me distances; and airway dimensions-NAS, SPAS, MPAS, IPAS, PNS-U, and Sp1-Sp2. Intergroup comparisons were performed using independent samples t-test or Mann-Whitney U test, and Binary Logistic Regression analysis was performed.

RESULTS

There were no statistically significant differences between the groups regarding hyoid bone position or airway dimensions. However, the OSA group exhibited significantly greater cranio-cervical and cranio-vertical angles: SN-CVT (OSA: 111.3°±10.4°; Control: 106.6°±8.0°; P = 0.018), SN-VER (OSA: 103.7°±3.5°; Control: 100.7°±5.4°; P = 0.007), and NL-VER (OSA: 95.4°±3.8°; Control: 92.8°±5.0°; P = 0.018). ANB and NL-VER angles had significant effects on the groups.

CONCLUSION

Pediatric patients with OSA, aged 9 to 16, demonstrated increased cranio-cervical and cranio-vertical angles, indicating a more extended head posture. This postural adaptation may serve as a clinical indicator of OSA in the pediatric orthodontic population.