Objective: To explore the polysomnography characteristics of different types of malocclusion in children. Methods: We retrospectively analyzed the clinical data of 763 school-age children with malocclusion who visited the Department of Orthodontics, Wuhan University School and Hospital of Stomatology and the Department of Otolaryngology-Head and Neck Surgery, Zhongnan Hospital of Wuhan University from January 2022 to December 2024. Among them, there were 393 males and 370 females, with an average age of 8 (range, 7-9) years.CBCT, electronic nasopharyngoscopy, and overnight polysomnography were collected. For the sagittal skeletal pattern, the skeletal patterns were categorized into Angle Class Ⅰ, Angle Class Ⅱ, and Angle Class Ⅲ according to the ANB angle. For the vertical dimension, classification was based on the ∠SN-MP angle, dividing the patients into low-angle, average-angle, and high-angle skeletal patterns. We compared the differences in various PSG indicators such as obstructive apnea-hypopnea index (OAHI), sleep efficiency (SE), proportion of rapid eye movement sleep (REM), respiratory-related micro-arousal index, and average and maximum heart rates during sleep among different groups. Also, we conducted a multiple linear regression analysis to explore the independent correlation between skeletal patterns and PSG characteristics. Results: In school-aged children, regarding sagittal skeletal patterns, compared with Class Ⅰ [1.0 (0.4, 2.0) events/h], children with Class Ⅱ [1.3 (0.6, 2.3) events/h] and Class Ⅲ [1.4 (0.5, 2.8) events/h] showed higher OAHI values (P<0.001), higher respiratory-related microarousal indices, and lower SE and REM sleep percentage (all P<0.001). Regarding vertical skeletal patterns, children with a high-angle facial pattern [2.1 (1.0, 4.5) events/h] had higher OAHI than those with low-angle [1.1 (0.5, 2.1) events/h] and average-angle facial patterns [1.2 (0.6, 2.0) events/h] (P<0.001), as well as a higher respiratory-related microarousal index, while, SE and REM sleep percentage were lower (all P<0.001). In addition, children with Class Ⅱ, Class Ⅲ, and a high-angle facial pattern generally had higher mean and peak heart rates during sleep (all P<0.001). After adjustment for potential covariates, multivariable linear regression analysis further confirmed the significance of these differences. Conclusion: Skeletal patterns in school-age children with malocclusion partially influence their sleep breathing characteristics, particularly in terms of the OAHI, SE, percentage of REM sleep, respiratory-related arousal index, and average and maximum heart rates during sleep. Children with Class Ⅱ, Class Ⅲ, and high-angle skeletal patterns are at higher risk for sleep-disordered breathing, suggesting that skeletal pattern should be considered in the early diagnosis and intervention of pediatric sleep respiratory disorders. 目的： 探讨不同类型错𬌗畸形儿童的多导睡眠监测（PSG）特征。 方法： 回顾性分析2022年1月至2024年12月因错𬌗畸形就诊于武汉大学口腔医院口腔正畸科和武汉大学中南医院耳鼻咽喉头颈外科的763名学龄期儿童的临床资料，其中男性393例，女性370例，平均年龄8（7±9）岁，完善锥形束计算机断层扫描（CBCT）、电子鼻咽喉镜、整夜PSG等检查。在矢状面上，根据A点-鼻根点-B点角（ANB）角度的不同，骨骼模式可分为骨性Ⅰ类、骨性Ⅱ类和骨性Ⅲ类；在垂直维度上，依据前颅底平面与下颌平面夹角（∠SN-MP）分为：低角骨面型、均角骨面型、高角骨面型。比较各组呼吸暂停低通气指数（OAHI）、睡眠效率（SE）、快速眼动睡眠期（REM）占比、呼吸相关微觉醒指数及睡眠期间平均心率和最快心率等PSG指标的差异。组间比较采用Kruskal-Wallis H 检验与协方差分析，并采用多元线性回归分析骨骼模式与PSG特征的独立相关性。 结果： 在学龄期儿童中，对于矢状面骨骼模式，与骨性Ⅰ类相比，骨性Ⅱ类和骨性Ⅲ类儿童的OAHI均升高［分别为1.0（0.4，2.0）次/h，1.3（0.6，2.3）次/h，1.4（0.5，2.8）次/h，P<0.001］，呼吸相关微觉醒指数均增高，SE和REM期占比均降低（均P<0.001）。垂直骨骼模式方面，高角骨面型儿童OAHI高于低角骨面型和均角骨面型［分别为2.1（1.0，4.5）次/h，1.2（0.6，2.0）次/h，1.1（0.5，2.1）次/h，P<0.001］，呼吸相关微觉醒指数亦较高，而SE和REM期占比均较低（均P<0.001）。此外，骨性Ⅱ类、骨性Ⅲ类以及高角骨面型儿童的睡眠期间平均和最快心率普遍较高（均P<0.001）。调整潜在协变量后，多元线性回归分析进一步验证了上述差异的显著性。 结论： 错𬌗畸形学龄期儿童的骨面型在一定程度上影响其睡眠呼吸特征，尤其是在OAHI、SE和REM期占比、呼吸相关微觉醒指数和睡眠期间平均及最快心率等方面。骨性Ⅱ类、骨性Ⅲ类及高角骨面型儿童在睡眠呼吸方面存在较高的风险，提示骨面型在儿童睡眠呼吸障碍的早期诊断和干预中应被重视。.
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PubMed · 2026-05-07
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PubMed · 2026-06-07