Atypical deglutition associated with obstructive sleep apnea in children

1. In children with obstructive sleep apnea syndrome, atypical deglutition was associated with more severe apnea.

2. Atypical deglutition was more strongly associated with increased pharyngeal collapsibility and altered facial measurements in children.

Evidence Rating Level: 2 (Good)

Tongue thrusting is a normal phenomenon in neonates, but lack of cessation by age 6 results in atypical deglutition. Atypical deglutition may be linked to pediatric obstructive sleep apnea (OSAS). As a result, correction of atypical deglutition through myofunctional therapy could improve OSAS symptoms. However, the relationship between atypical deglutition and OSAS is unclear.

This cross-sectional study assessed the prevalence of atypical deglutition in children with OSAS. 90 children aged 6-18 years, with moderate to severe OSA determined by night polysomnography, were included in the study. Each participant’s swallowing pattern was identified by an orthodontist and classified into two categories: typical and atypical deglutition. The only exclusion criterion was the presence of a syndromic disease. All children underwent a systematic evaluation which included data such as height, weight, neck circumference, and symptoms of snoring and/or sleep-disordered breathing. The primary outcome was to measure the prevalence of atypical deglutition in children with moderate to severe OSAS.

In children with atypical deglutition compared with those with typical deglutition, labial incompetence, narrow maxilla, anterior open bite, low tongue position, and the presence of asymmetry on the frontal examination of the face were all more frequent. Higher rates of atypical deglutition were seen in children with mixed or permanent dentition with OSAS, suggesting an association between OSAS and atypical deglutition. A limitation of the study is the modified use of the term “atypical deglutition” which has not yet been clinically evaluated in other studies. Nonetheless, the study suggests that identifying atypical deglutition in children with OSAS can help guide therapeutic management.

Click here to read this study in Journal of Sleep Research.

Image: PD

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