Can Orthodontic Expansion Really Help Teenagers with Sleep Apnoea?

Sleep matters. It helps us learn, grow, and feel ready for the day. But some teenagers have obstructive sleep apnoea, a condition where breathing becomes partly blocked during sleep. This may lead to snoring, broken sleep, and drops in blood oxygen.

A new study looked at whether orthodontic expansion could help.

Orthodontic expansion is a treatment that makes the upper jaw wider. It is often used when the upper jaw is too narrow or when the back teeth do not fit together well. In this study, the researchers wanted to know if expansion could also improve breathing during sleep.

What did the researchers do?

The study included 45 orthodontic patients aged 14 to 17. All had a narrow upper jaw and breathed through their mouths. They were past the main stage of puberty, so jaw growth was less likely to explain any changes.

They placed the teenagers at random into one of three treatment groups. Each group used a different type of rapid palatal expander. One type used small screws in the roof of the mouth. This type is called MARPE.

The researchers checked the teenagers before treatment and again about three months later. They measured breathing during sleep, airflow through the nose, tooth and jaw changes, and daytime sleepiness.

They also compared the results with a group of healthy teenagers who did not have treatment.

What did they find?

The main result was encouraging. After expansion, the treatment groups had fewer breathing pauses or restrictions during sleep. They also had fewer drops in blood oxygen.

One measure used in the study was the apnoea-hypopnoea index, or AHI. This counts breathing events during sleep. A lower number is better. In all three treatment groups, the AHI fell after expansion.

The MARPE group showed the biggest improvement. This may suggest that expansion supported by small screws can be useful for some older teenagers.

However, the teenagers did not report clear changes in daytime sleepiness. Their scores were in the normal range before and after treatment. This is important because better test results do not always mean a person feels very different.

What should we make of this?

This was a well-planned randomised trial, which makes it more useful than studies that only look back at old patient records. Still, it was a small study and the follow-up was short.

The sleep test used was practical, but it was not the most detailed test available. A full overnight sleep study is usually seen as the best way to assess sleep apnoea.

The findings do not mean that orthodontic expansion is a cure for every teenager who snores or has sleep apnoea. Sleep problems can have many causes. Weight, nose and throat health, hormones, and the shape of the airway can all play a part.

But the study gives us a helpful clue: for teenagers with a narrow upper jaw, expansion may improve some measures of sleep breathing. More large studies, with longer follow-up, are still needed.

If you are worried about snoring, pauses in breathing, or poor sleep, speak to a parent, dentist, orthodontist, or doctor. Good sleep is too important to ignore.

Adapted from Kevin O’Brien’s discussion of the trial, “New evidence from a trial of Orthodontic Expansion and Sleep Apnoea in Teenagers.”