Radiography used to identify teens with sleep apnea

Fifteen percent of all teenagers in the United States undergo orthodontic treatment. Craniofacial Risk Index (CRI) scores, calculated from the radiographs routinely obtained on all orthodontic patients, correctly classified 80% of apneic and 78% of non-apneic adult snorers into high-and low-Respiratory Disturbance Index (RDI) groups.

(Sleep apnea is a temporary suspension of breathing during sleep, with potentially serious consequences.) Researchers at Case Western Reserve University (Cleveland, OH) wondered whether similar radiographic use could identify adolescent orthodontic patients with high RDI scores.

The investigators studied the case histories of 590 patients between 7 and 18 years of age attending the orthodontic clinic at Case Dental School. They recorded age, gender, height and weight (abstracted from patient chart) along with tongue length and hyoid-to-mandibular-plane distance (measured from lateral cephalograms) in a linear model to generate a CRI score. The 30 patients with the highest and 30 patients with the lowest CRI scores were asked to undergo unattended in-home sleep monitoring to determine their RDI score.

Since children in this small pilot sample with high CRI scores exhibited somewhat higher RDI scores than those with low CRI scores, it may be possible to use cephalometric radiographs to identify teenagers at risk for sleep-disordered breathing.