Rapid maxillary expansion and its impact on sleep apnea in children aged 5 to 8 years: a retrospective study

Abstract

Objective: Determine the impact of early transverse maxillary expansion on the symptomatic manifestation of sleep apnea in children aged 5-8 years. Methods: Nineteen patients (mean age: 6.84 years) with maxillary constriction underwent rapid maxillary expansion (RME) for orthodontic treatment. Inclusion criteria: age 5-8 years, Apnea-Hypopnea Index (AHI) > 1, treated with Memory screw Hyrax appliance, under pediatric sleep physician care. Exclusion criteria: non-compliance, re-evaluation delays (> 3 months). Primary variable: AHI before (T0) and after (T1) expansion. Treatment ended based on malocclusion correction. AHI comparisons included dentition status and gender as secondary variables. Results:Apaired t-test showedno significant difference in themean AHI between T0 (4.05±2.55) and T1 (3.68±3.12) for primary variables (p>0.05). At T0, no significant AHI difference was found between genders (F: 3.21±2.47; M: 4.09±2.87, p>0.05). After expansion (T1), a significant change was observed between genders (F: 1.75±1.03; M: 5.18±3.68, p<0.05). There was also no significant difference in AHI changes based on dentition status. A negative correlation was found between AHI changes and transverse changes and at canine and molar levels. Conclusion: No significant evidence was found to support the effectiveness of early maxillary expansion in improving sleep apnea among children with maxillary constriction. However, the gen-der-specific responses and the potential dose-response relation-ship between maxillary expansion and AHI reduction highlight the complexity of treating pediatric OSA.