Sleep related breathing disorders (SRBD) in children have a reported prevalence of 4-11% and manifest as behavioral, physical, and/or academic deficiencies. SRBD in children include snoring, obstructive sleep apnea (OSA), and hypopnea. Unlike adults, OSA incidence in pediatric patients occurs equally in males and females, with the greatest incidence from ages 2-8 years old. The greater incidence during this age range is primarily due to larger pharyngeal lymphatic tissues, which regress as the patient progresses into adolescence. After puberty, the prevalence of OSA increases more in boys than girls, which could be due to testosterone-induced changes. The gold standard for measuring SRBD is an overnight polysomnograph, which is burdensome to both the patient and the parent. For this reason, numerous questionnaires have been created to help identify patients at risk for SRBD. The Pediatric Sleep Questionnaire (PSQ) is a 22-point questionnaire which can be scored quickly and easily. When more than one third of the answers are answered positively, there is an increased likelihood that the patient would have positive signs of SRBD on a polysomnograph. With a specificity of 81% and a sensitivity of 85%, the questionnaire is a powerful tool for identifying patients who may be at a higher risk for SRBD. By looking at 1500 consecutive PSQ given to all patients under the age of 18 as part of the routine medical history, the prevalence of SRDB in pediatric orthodontic patients in a private practice in Western Pennsylvania will be estimated in an effort to describe how common this disorder may be in a common orthodontic environment
