Sleep Apnea: Children May Benefit from UBC Device

Prof. Alan Lowe’s invention, an oral appliance called Klearway ™, is being tested to treat sleep apnea in children - photo by Martin Dee
Prof. Alan Lowe’s invention, an oral appliance called
Klearway ™,
is being tested to treat sleep apnea in children – photo
by Martin Dee

UBC Reports | Vol. 55 | No. 2 | Feb.
5, 2009

By Catherine Loiacono

Children suffering from obstructive sleep apnea (OSA) may
soon be sleeping better thanks to a new use of a device being
studied in UBC’s Division of Orthodontics, Faculty of

The study, led by Prof. Alan Lowe, is the first to test and
document the effectiveness of an oral appliance called Klearway™ in
children with OSA.  The devise is already being already
being used in 30,000 adults world wide.

Habitual snoring in
children can be an indicator of OSA, which is characterized
by cessations of breathing and problems with sleep, including
restless sleep. OSA occurs when a child repeatedly gasps and
stops breathing during sleep because the upper airway is obstructed.

During sleep, the tongue can be sucked back against the back
of the throat, obstructing the airway. The Klearway™ oral
appliance is made of clear acrylic resin and is similar to
two connected orthodontic retainers. It prevents the lower
jaw from dropping down and back and keeps the teeth together
during sleep.

“The preliminary results from this clinical trial are
promising and better than expected,” says Lowe, who invented
the UBC technology. “What is most surprising is how quickly
the appliance works in children. In just a matter of months,
we have found that children who wear the appliance show dramatic
improvements in sleep and significantly improve how their upper
and lower teeth fit together.”

Although snoring in children is a common condition that may
affect up to 27 per cent of kids aged two to 12, OSA affects
from one to 10 per cent of children who snore. Many of these
children also exhibit enlarged tonsils.

The effects of OSA in children can include attention-deficit
disorder, behavioural problems, poor academic performance,
failure to thrive, bedwetting, cardiopulmonary disease and,
in some cases, obesity and type II diabetes.

The study shows promise for Klearway™ to treat OSA particularly
in those children with prominent upper front teeth and short
lower jaws — a condition called malocclusion. The distance
between the upper and lower front teeth was reduced and the
vertical incisor overlap decreased.

According to the study, when compared to baseline recordings,
the Klearway™ appliance demonstrated improved minimum
blood oxygen levels. The results also show that the episodes
of not breathing were reduced from eight per hour pretreatment
to 2.4 posttreatment.

“One of our patients’ grandmothers reported that
she suspected a problem because her grandson was often very
tired and reported that he fell asleep on the bus on the way
home from school,” says Lowe. “After using the
device for a few months, the patient and grandmother have seen
a tremendous improvement in sleep, energy, concentration and
overall mood.”

The Klearway™ appliance effectively increases the size
of the airway during sleep by creating more room at the back
of the throat at the base of the tongue. The appliance fits
over the top and bottom teeth and gradually moves the lower
jaw forward giving the patient more room to breath.

“In prepubescent children with this condition, Klearway™ may
also correct the malocclusion,” says Lowe. “It
has the potential to treat OSA because it opens the airway
and decreases the mismatch between the upper and lower teeth.”

Lowe cautions that not all children who snore suffer from
OSA, nor do all OSA patients snore. Assessment by the family
physician and referral to a pediatric sleep specialist are
required before a definitive diagnosis of OSA can be made and
therapy decisions determined.