Mouth breathing is very common in children. Mouthbreathing syndrome is characterized by tiredness, daytime sleepiness, failure to thrive, restless sleep, nocturnal enuresis and poor school performance. However, this symptom has several causes and it is necessary to elucidate more details about this entity. AIM: Compare the findings of daytime sleepiness, headache, nocturnal enuresis, poor school performance and attention deficit and bruxism in subjects that present mouth breathing according to the following diagnosis: allergic rhinitis, adenoidal hyperplasia and adenotonsillar hyperplasia. STUDY DESIGN: Transversal cohort study. MATERIAL AND METHOD: This is a prospective study of 142 patients from 2 to 16 years old. After ENT evaluation, patients were classified in 3 groups according to the following diagnosis: allergic rhinitis, adenoidal hyperplasia, adenotonsillar hyperplasia. Parents and caregivers answered a questionnaire about night symptoms in order to describe the presence of sleep apnea and specific questions about: morning headaches, school performance and attention deficit, daytime sleepiness, restless sleep, nocturnal enuresis and bruxism. RESULTS: Mouth breathing is common in boys. Children with adenotonsillar hyperplasia are younger and present more snoring and sleep apnea. They present also poor school performance, bruxism, nocturnal enuresis and restless sleep, which are correlated to sleep apnea, differing from the allergic rhinitis group. Significant findings of daytime sleepiness and morning headaches were not found. CONCLUSION: Bruxism, enuresis, restless sleep and poor school performance are related to sleep apnea and more frequent in subjects with adenotonsillar hyperplasia. The investigation of sleep apnea in children with mouth breathing is mandatory, as well as the determination of its cause.
mouth breathing; child; adenoid; tonsil; rhinitis
