Evaluation of Association of Transverse Arch Dimensions and AIrway Dimensions in Children Aged 6-12 Years With Mild Sleepdisordered Breathing: A Case Control Study

Background: Sleep-disordered breathing (SDB) is a broad term encompassing conditions that disrupt normal breathing during sleep, ranging from habitual snoring to obstructive sleep apnoea (OSA). Mild SDB is linked to mouth breathing, airway obstruction, and altered craniofacial growth patterns. Such children often have narrow maxillary arches, high palatal vaults, and compromised airway spaces, exacerbating symptoms. Understanding the relationship between transverse dental arch dimensions and airway morphology can help identify predisposing craniofacial patterns and enable timely interventions to improve airway health. Aim: To assess the relationship between transverse dental arch dimensions and airway dimensions in mouth-breathing children aged 6-12 years diagnosed with mild sleep-disordered breathing (SDB). Study Design And Setting: This was a single-centre, observational, case-control study conducted in the Department of Paediatric and Preventive Dentistry in a tertiary care hospital setting. Material And Methods: A sample size of 35 per group was calculate using 90% power. A total of 69 children were recruited, including 33 cases (with mouth breathing, mild SDB, PSQ ≥0.33) and 36 controls (PSQ <0.33, no mouth breathing or SDB symptoms). Intercanine width, intermolar width, and palatal depth were measured using dental casts. Nasopharyngeal and oropharyngeal airway dimensions were assessed via lateral cephalograms. Statistical Analysis: Unpaired t-tests and chi-square tests compared groups. Pearson's correlation and multivariate regression assessed relationships between PSQ scores and anatomical dimensions. Results: Children in the cases group exhibited signicantly higher PSQ scores (p < 0.001), greater palatal depth (p < 0.001), and reduced nasopharyngeal and oropharyngeal dimensions (p < 0.001) compared to controls. Regression analysis identied palatal depth as a positive predictor (p < 0.001), and nasopharyngeal and oropharyngeal widths as negative predictors (p = 0.019, p = 0.013 respectively) of PSQ scores. Conclusions: Craniofacial morphology, particularly increased palatal depth and reduced airway space, is signicantly associated with mild SDB in children. The ndings also support the hypothesis that mouth breathing is not just a symptom but also a contributing factor to structural changes that predispose children to SDB. Early identication of these features may aid in timely intervention. Clinical Significance: Early detection of craniofacial and airway changes in children with mild sleep-disordered breathing enables timely intervention to prevent progression and support healthy growth.