Obstructive sleep apnea prevalence in subjects with skeletal class II or class III with maxillary hypoplasia deformities waiting for orthognathic surgery

Introduction: Orthognatic surgery (OS) could be an alternative treatment to continuous positive airway pressure (CPAP) therapy in patients with skeletal class II or class III with maxillary hypoplasia deformities (SCII-III+MhD) suffering also from obstructive sleep apnea (OSA) with potential satisfactory and permanent results for both disorders. The aim of the present study was to determine OSA prevalence in subjects suffering from SCII-III+MhD waiting for OS regardless of OSA symptoms. Methods: All subjects with SCII-III+MhD waiting for OS were studied regardless of OSA symptoms. Sleep study (respiratory polygraphy and polysomnography [PSG]), anthropometrical, OSA symptoms, sleep quality and Epworth Sleepiness Scale [ESS] data were collected. OSA was defined by an apnea-hypoapnea index (AHI) above 5 events/hour and severe OSA by an AHI above 30 events/hour. Results: From 34 subjects included in the waiting list, 22 patients (65%) were evaluated. From the remaining 12 patients (35%), 3 refused and 9 could not be evaluated. Regarding age, sex and skeletal deformity, there were no differences between groups: studied subjects (n = 22) versus non- studied subjects (n = 12). The overall prevalence of OSA was 13.6%. Only one subject had severe OSA with CPAP therapy indication (PSG, female, 44 years, 29 Kg/m2, ESS 24, AHI 59/hour, supine AHI 75/hour, non-supine AHI 57/hour, 64% obstructive apneas). Conclusions: OSA prevalence and CPAP indication in subjects waiting for OSA due to SCII-III+MhD are low, thus systematic screening does not seem to be justified. Further studies with larger sample sizes are needed to confirm these results.