treatment of OSA.Nevertheless, in practice, the compliance is often not optimal because of the discomfort, noise, and interference with the way of life.Other forms of treatment, such as mandibular advancement device, positional therapy, hypoglossal nerve stimulation, and upper airway surgery, are frequently prescribed to patients who have anatomical obstruction or cannot tolerate CPAP.Here, dentofacial orthopedics has become a prominent role in the management of OSA, especially in patients who have a definite maxillary constriction or craniofacial abnormalities. 6 IntroductIonObstructive sleep apnea (OSA) is a multifactorial respiratory disorder.It involves the repeated collapse of the upper airways during sleep, which leads to interrupted ventilation and sleep fragmentation.This on-and-off hypoxia-reoxygenation process triggers the systemic inflammatory pathways and changes autonomic tone, predisposing to broader morbidities such as cardiovascular disease, metabolic dysfunction, neurocognitive decline, and reduced quality of life. 1 Epidemiological research indicates that OSA impacts close to 1 billion people worldwide, with the prevalence rate of between 9 and 38% in adults and >10% in children. 2 Obstructive sleep apnea is traditionally viewed as a disease of obese middle-aged men, but is increasingly understood as strongly heterogeneous, with phenotypes that are determined not only by excess adiposity and airway compliance, but also by craniofacial anatomy, neuromuscular responsiveness, ventilatory control stability, and variable arousal threshold. 3Within this group, the maxillomandibular skeletal discrepancies, specifically transverse maxillary deficiency, have become one of the most important factors that lead to an increase in airway resistance and predispose to collapse during sleep. 4Such structural constraints make the nasal cavity and posterior airway space narrow, increase nasal resistance, and encourage mouth breathing, which in itself interferes with the coordination of airway muscles. 5he most effective nonsurgical treatment is continuous positive airway pressure (CPAP), that is usually used as first-line 1-
Abdurahman et al. (Tue,) studied this question.