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(Chest. 1996;109:664-672.)
© 1996 American College of Chest Physicians

Sleep, Breathing, and Cephalometrics in Older Children and Young Adults

Part I—Normative Values

Christine Acebo PhD1; Richard P. Millman MD, FCCP2; Cynthia Rosenberg DDS3; Anita Cavallo MD4; and Mary A. Carskadon PhD1

1 From the Sleep and Chronobiology Research Laboratory, Department of Psychiatry and Human Behavior, E.P. Bradley Hospital/Brown University, East Providence, RI
2 From the Sleep Disorders Center, Rhode Island Hospital/Brown University, Providence
3 From the Department of Medicine, and Department of Plastic Surgery, Rhode Island Hospital/Brown University, Providence
4 From the Department of Pediatrics, Children's Hospital Medical Center, University of Cincinnati College of Medicine

Study objectives: Aims were (1) to provide normative values for sleep and sleep-related breathing variables and physical features (cephalometrics, body mass index [BMI], and tonsillar size) in older children/adolescents and young adults, (2) to describe sex and age group differences, and (3) to evaluate relationships between physical features and sleep-related breathing variables.

Design: Standard polysomnographic variables describing sleep and breathing were measured during a single night. Cephalometric measures were obtained from a standing lateral skull radiograph.

Subjects: Normal, healthy boys (n=23; mean age=13.3±2.1 years), girls (n=22; mean age=13.8±1.8 years), men (n=23; mean age=22.2±1.5 years), and women (n=24; mean age=22.4±1.8 years) with BMI less than 27 were evaluated.

Results: Sleep variables showed age group and sex differences consistent with published norms. Slow-wave sleep and rapid eye movement (REM) latency declined with age; transient arousals increased with age. Sleep-related breathing variables showed few changes related to age group or sex: small but statistically significant sex differences were found for arterial oxygen saturation nadir (lower in male subjects) and respiration disturbance index innon-REM sleep (greater in male subjects). Differences in cephalometric measures largely reflected normal growth and expected sex differences. No significant relationships between sleep-related breathing variables and physical findings were observed.

Conclusions: These data provide well-controlled normative values for sleep, breathing, and cephalometrics in a group of normal older children, adolescents, and young adults. The data provide useful reference points for patients of these ages in whom sleep apnea is suspected, particularly since such clinical studies are normally based on first-night polysomnography. Furthermore, these values represent developmentally appropriate grouping of the data.

Key Words: adolescent • apnea • body mass index • cephalometrics • development • normative • sleep • young adult

Submitted on April 7, 1995
Accepted on September 25, 2007




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