Short-term changes in sleep dynamics before and after surgical orthodontic treatment

Purpose To investigate short-term changes in sleep respiratory status and respiratory disturbance index (RDI) pre- and post-orthognathic surgery and determine the period during which morphological changes in the airway and surgical invasion affect postoperative sleep dynamics.Materials and Methods This study enrolled patients with skeletal mandibular prognathism who underwent mandibular ramus sagittal split osteotomy alone (mandible-only group, n = 10) or mandibular and maxillary surgery (two-jaw surgery group, n = 13). Simplified sleep tests were conducted pre-orthognathic surgery (T0) and at 7 (T1), 14 (T2), and 21 (T3) days postoperatively. Correlations between inflammation status at the surgical site before and during the postoperative management period were analysedResults RDI values at T0, T1, T2, and T3 were 3.5 ± 2.1, 5.0 ± 3.1, 4.3 ± 2.7, and 3.2 ± 1.4 in the mandible-only group, and 2.9 ± 2.0, 4.7 ± 2.5, 4.4 ± 2.4, and 2.8 ± 0.9 in the two-jaw surgery group, respectively. In the two-jaw surgery group, the RDI increased significantly between T0 and T1. The RDI in both groups exhibited a declining trend between T1 and T2 and decreased significantly between T2 and T3. C-reactive protein levels and white blood cell counts increased significantly between T0 and T1 and decreased significantly between T1 and T2 in both groups. The airway area was reduced significantly in the mandible-only group.Conclusion Temporary swelling of tissues around the osteotomy site increases the RDI in orthognathic surgery. Airway management for approximately 3 weeks is important until postoperative recovery is complete.