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The influence of snoring, mouth breathing and apnoea on facial morphology in late childhood: a three-dimensional study.
BMJ Open. 2015 Sep 08; 5(9):e009027.BO

Abstract

OBJECTIVE

To explore the relationship between the prevalence of sleep disordered breathing (SDB) and face shape morphology in a large cohort of 15-year-old children.

DESIGN

Observational longitudinal cohort study

SETTING

Avon Longitudinal Study of Parents and Children (ALSPAC), South West of England.

PARTICIPANTS

Three-dimensional surface laser scans were taken for 4784 white British children from the ALSPAC during a follow-up clinic. A total of 1724 children with sleep disordered breathing (SDB) and 1862 healthy children were identified via parents' report of sleep disordered symptoms for their children. We excluded from the original cohort all children identified as having congenital abnormalities, diagnoses associated with poor growth and children with adenoidectomy and/or tonsillectomy.

MAIN OUTCOME MEASURES

Parents in the ALSPAC reported sleep disordered symptoms (snoring, mouth breathing and apnoea) for their children at 6, 18, 30, 42, 57, 69 and 81 months. Average facial shells were created for children with and without SDB in order to explore surface differences.

RESULTS

Differences in facial measurements were found between the children with and without SDB throughout early childhood. The mean differences included an increase in face height in SDB children of 0.3 mm (95% CI -0.52 to -0.05); a decrease in mandibular prominence of 0.9° (95% CI -1.30 to -0.42) in SDB children; and a decrease in nose prominence and width of 0.12 mm (95% CI 0.00 to 0.24) and 0.72 mm (95% CI -0.10 to -0.25), respectively, in SDB children. The odds of children exhibiting symptoms of SDB increased significantly with respect to increased face height and mandible angle, but reduced with increased nose width and prominence.

CONCLUSIONS

The combination of a long face, reduced nose prominence and width, and a retrognathic mandible may be diagnostic facial features of SBD that may warrant a referral to specialists for the evaluation of other clinical symptoms of SDB.

Authors+Show Affiliations

Applied Clinical Research & Public Health, Dental School, Wales, UK.Applied Clinical Research & Public Health, Dental School, Wales, UK.Applied Clinical Research & Public Health, Dental School, Wales, UK.Applied Clinical Research & Public Health, Dental School, Wales, UK.Applied Clinical Research & Public Health, Dental School, Wales, UK.Applied Clinical Research & Public Health, Dental School, Wales, UK.School of Computer Science & Informatics, Cardiff University, Wales, UK.School of Computer Science & Informatics, Cardiff University, Wales, UK.Avon Longitudinal Study of Parents and Children, University of Bristol, Bristol, UK.Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26351193

Citation

Al Ali, Ala, et al. "The Influence of Snoring, Mouth Breathing and Apnoea On Facial Morphology in Late Childhood: a Three-dimensional Study." BMJ Open, vol. 5, no. 9, 2015, pp. e009027.
Al Ali A, Richmond S, Popat H, et al. The influence of snoring, mouth breathing and apnoea on facial morphology in late childhood: a three-dimensional study. BMJ Open. 2015;5(9):e009027.
Al Ali, A., Richmond, S., Popat, H., Playle, R., Pickles, T., Zhurov, A. I., Marshall, D., Rosin, P. L., Henderson, J., & Bonuck, K. (2015). The influence of snoring, mouth breathing and apnoea on facial morphology in late childhood: a three-dimensional study. BMJ Open, 5(9), e009027. https://doi.org/10.1136/bmjopen-2015-009027
Al Ali A, et al. The Influence of Snoring, Mouth Breathing and Apnoea On Facial Morphology in Late Childhood: a Three-dimensional Study. BMJ Open. 2015 Sep 8;5(9):e009027. PubMed PMID: 26351193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The influence of snoring, mouth breathing and apnoea on facial morphology in late childhood: a three-dimensional study. AU - Al Ali,Ala, AU - Richmond,Stephen, AU - Popat,Hashmat, AU - Playle,Rebecca, AU - Pickles,Timothy, AU - Zhurov,Alexei I, AU - Marshall,David, AU - Rosin,Paul L, AU - Henderson,John, AU - Bonuck,Karen, Y1 - 2015/09/08/ PY - 2015/9/10/entrez PY - 2015/9/10/pubmed PY - 2016/6/24/medline KW - ALSPAC KW - apnoea KW - mouth-breathing KW - sleep disordered breathing KW - snoring KW - three-dimensional imaging SP - e009027 EP - e009027 JF - BMJ open JO - BMJ Open VL - 5 IS - 9 N2 - OBJECTIVE: To explore the relationship between the prevalence of sleep disordered breathing (SDB) and face shape morphology in a large cohort of 15-year-old children. DESIGN: Observational longitudinal cohort study SETTING: Avon Longitudinal Study of Parents and Children (ALSPAC), South West of England. PARTICIPANTS: Three-dimensional surface laser scans were taken for 4784 white British children from the ALSPAC during a follow-up clinic. A total of 1724 children with sleep disordered breathing (SDB) and 1862 healthy children were identified via parents' report of sleep disordered symptoms for their children. We excluded from the original cohort all children identified as having congenital abnormalities, diagnoses associated with poor growth and children with adenoidectomy and/or tonsillectomy. MAIN OUTCOME MEASURES: Parents in the ALSPAC reported sleep disordered symptoms (snoring, mouth breathing and apnoea) for their children at 6, 18, 30, 42, 57, 69 and 81 months. Average facial shells were created for children with and without SDB in order to explore surface differences. RESULTS: Differences in facial measurements were found between the children with and without SDB throughout early childhood. The mean differences included an increase in face height in SDB children of 0.3 mm (95% CI -0.52 to -0.05); a decrease in mandibular prominence of 0.9° (95% CI -1.30 to -0.42) in SDB children; and a decrease in nose prominence and width of 0.12 mm (95% CI 0.00 to 0.24) and 0.72 mm (95% CI -0.10 to -0.25), respectively, in SDB children. The odds of children exhibiting symptoms of SDB increased significantly with respect to increased face height and mandible angle, but reduced with increased nose width and prominence. CONCLUSIONS: The combination of a long face, reduced nose prominence and width, and a retrognathic mandible may be diagnostic facial features of SBD that may warrant a referral to specialists for the evaluation of other clinical symptoms of SDB. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/26351193/The_influence_of_snoring_mouth_breathing_and_apnoea_on_facial_morphology_in_late_childhood:_a_three_dimensional_study_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&pmid=26351193 DB - PRIME DP - Unbound Medicine ER -