The Open Dentistry Journal

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Craniofacial Characteristics Related to Daytime Sleepiness Screened by the Paediatric Daytime Sleepiness Scale

Min Gu1, Yanqi Yang*, Angus C.H Ho2, Ricky W.K Wong2, Urban Hägg3, Colman P.J McGrath4
1 Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
2 Department of Dentistry and Maxillofacial Surgery Cleft Center (Craniofacial Orthodontics), United Christian Hospital, Hong Kong SAR, China
3 Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
4 Department of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China


The present cross-sectional study aimed to assess daytime sleepiness in Chinese adolescents using the Paediatric Daytime Sleepiness Scale (PDSS) and to identify associations between PDSS answers and craniofacial characteristics. A group of 265 Chinese adolescents aged 11-17 years self-completed the PDSS, and their extra- and intra-oral craniofacial characteristics were recorded. Among the participants, 59.7% (157) experienced one or more daytime sleepiness events. No significant associations were found between total PDSS scores and the craniofacial parameters, but when PDSS answers were assessed at the item level, several craniofacial characteristics were found to be positively associated with daytime sleepiness, such as hypertrophic tonsils (P = 0.05), a relatively large tongue (P < 0.01), a bilateral Class II molar relationship (P < 0.05) and increased overjet (P < 0.05). A short lower face (P < 0.01) and a convex profile (P < 0.01) were found to be negatively associated with daytime sleepiness. Daytime sleepiness is commonly reported among Chinese adolescents seeking orthodontic treatment and there are potential associations between the condition and craniofacial characteristics. An assessment of daytime sleepiness is recommended to orthodontists in young patients presenting with hypertrophic tonsils, relative large tongues and Class II tendency malocclusions, and appropriate medical referrals should also be considered.

Keywords: Adolescents, Chinese, craniofacial abnormalities, sleepiness.

Article Information

Identifiers and Pagination:

Year: 2015
Volume: 9
First Page: 31
Last Page: 40
Publisher Id: TODENTJ-9-31
DOI: 10.2174/1874210601509010031

Article History:

Received Date: 8/10/2014
Revision Received Date: 10/11/2014
Acceptance Date: 27/11/2014
Electronic publication date: 30 /1/2015
Collection year: 2015

© Gu et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China; Tel: 00852-28590252, Fax: 00852-25593803; E-mail:

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