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

Sleep Apnea: Children May Benefit from UBC Device

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 Dentistry.

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.