Sleep apnea disorder has recently emerged as a significant public health issue. While the prevalence of obesity is on the rise among children, it is one of the main risk factors associated with apnea. Upper airway dimensions and morphology seem to be major components of obstructive sleep apnea (OSA) and can be affected by different craniofacial patterns. The purpose of this retrospective, cross-sectional pilot study is to correlate gender, Body Mass Index, risk for OSA, neck circumference, and 3-D oropharyngeal airway dimensions in children and adolescents with different antero-posterior (AP) and vertical craniofacial skeletal patterns. A total of 86 pre-orthodontic treatment records in the age group of 8-16 years were analyzed. 3-D volumetric skeletal tracing and oropharyngeal airway measurements were completed for each scan. Each subject was classified into AP Classes I, II, and III groups; vertical Normodivergent, Hypodivergent, and Hyperdivergent groups; and combined AP-vertical subgroups. Oropharyngeal airway measurements included the total oropharyngeal airway volume, minimum cross-section area, depth, width, and perimeter. Mean, standard deviation, and Pearson\u27s correlation coefficient were performed to evaluate the relationships among variables. There were one or more correlations, but not all, between gender, Body Mass Index, risk for OSA, neck circumference, and 3-D oropharyngeal airway dimensions in children and adolescents among the AP groups, vertical groups, and nine craniofacial subgroups (P \u3c 0.05 and P \u3c 0.01). This investigation aimed to determine whether patients with certain skeletal deficiencies are predisposed to upper airway obstruction. Early identification and management of airway problems in children and adolescents may prevent or minimize the sequelae and adverse dental implications of obstructive sleep apnea. Our small, young groups of sample were mainly in the healthy weight category with normal size neck circumference. Therefore, this limited our overall findings. Currently, sleep disorders are not well researched and understood. Long-term goal of our study is to further investigate this study in larger sample size taken into considerations predisposing factors (i.e. abnormal neural regulation and intrinsic muscle weakness) and pathologic conditions (allergies, polyps, and tumors). The physiology of the airway, influenced by these confounding factors, has an essential role in determining whether patients with certain skeletal deficiencies are predisposed to upper airway obstruction. Sleep apnea is a complex phenomenon that warrants further research regarding the physiology and anatomy of the airway and craniofacial structures
