Sleep and Breathing

, Volume 23, Issue 4, pp 1359–1369 | Cite as

Changes in craniofacial and airway morphology as well as quality of life after passive myofunctional therapy in children with obstructive sleep apnea: a comparative cohort study

  • Li-Chuan Chuang
  • Yi-Jing Hwang
  • Yun-Chia Lian
  • Michèle Hervy-Auboiron
  • Paola Pirelli
  • Yu-Shu HuangEmail author
  • Christian Guilleminault
Dentistry • Original Article



To examine the craniofacial and airway morphology as well as the quality of life before and after passive myofunctional therapy (PMFT) for 1 year in children with obstructive sleep apnea (OSA).


Forty children with OSA wearing an oral device nightly (treatment group) and seventeen without the device (control group) were followed up for 1 year. Lateral cephalometric radiography, polysomnography (without participants wearing the oral device), and quality of life survey (OSA-18) were performed before and after the study period.


The apnea-hypopnea index (AHI) during sleep, REM AHI, hypopnea count, and desaturation count in the treatment group dropped significantly, compared with the control group. The craniofacial linear measurements increased significantly in both groups, while the length of mandible (Co-Gn) and anterior facial height (N-Me) became significantly larger in the treatment group. For the airway morphology, the intergroup comparison showed that OPha-Ophp (distance between anterior and posterior sides of oropharynx) increased significantly in the treatment group. For quality of life, the intergroup comparison found statistically significant improvements in the following in the treatment group, based on the OSA-18 survey: loud snoring, dysphagia, mood swings, discipline problems, difficulty awakening, total score for the emotional distress portion, and total survey score.


Preliminary evidence is substantiated for the benefits of 1-year PMFT using an oral device with a built-in tongue bead, including improvements in nasal breathing during sleep, mandible linear growth (Co-Gn and N-Me), airway morphology (OPha-Ophp), and patients’ quality of life.


Pediatric obstructive sleep apnea syndrome Passive myofunctional therapy Oral appliance Craniofacial morphology Airway morphology 



This study was supported by the Chang Gung Memorial Hospital (CMRPG3G1951 and CMRPG3H1591; Grant Recipient: Li-Chuan Chuang). The data of the study were first presented at the 5th International Pediatric Sleep Association Congress, Paris, April, 2018.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board of the Human Investigation Committee of Chang Gung Memorial Hospital and Chang Gung University (IRB 104-9308A3), as well as the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent from the legal guardian of each participant was obtained prior to the investigation.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Li-Chuan Chuang
    • 1
    • 2
  • Yi-Jing Hwang
    • 1
  • Yun-Chia Lian
    • 1
    • 2
  • Michèle Hervy-Auboiron
    • 3
  • Paola Pirelli
    • 4
  • Yu-Shu Huang
    • 5
    Email author
  • Christian Guilleminault
    • 6
  1. 1.Department of Pediatric DentistryChang Gung Memorial Hospital at LinkouTaoyuanTaiwan
  2. 2.Graduate Institute of Craniofacial and Dental Science, College of MedicineChang Gung UniversityTaoyuanTaiwan
  3. 3.Orthodontic InstituteNoisy-LesecFrance
  4. 4.Department of Clinical Science and Translational MedicineUniversity of Rome “Tor Vergata”RomeItaly
  5. 5.Department of Pediatric Psychiatry and Sleep CenterChang Gung Memorial Hospital and College of MedicineTaoyuan CityTaiwan
  6. 6.Stanford University Sleep Medicine DivisionStanfordUSA

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