# Prevalence of and Sex-Related Differences in Excessive Daytime Sleepiness in Adolescents and Young Adults with Malocclusion

## TL;DR

This study finds that young adults with malocclusion, especially women, are more likely to experience excessive daytime sleepiness, which could impact their health and academic performance.

## Contribution

The study identifies sex-related differences in EDS prevalence among adolescents and young adults with malocclusion, highlighting the need for early screening.

## Key findings

- ESS scores increased significantly with age in adolescents and young adults with malocclusion.
- Females had higher ESS scores and a higher EDS prevalence (32.1%) compared to males (16.7%) in young adults.
- EDS prevalence suggests a need for early identification and multidisciplinary intervention in this population.

## Abstract

Background/Objectives: Excessive daytime sleepiness (EDS) has been suggested to negatively affect academic performance and behavior. Malocclusion is reportedly a risk factor for sleep-disordered breathing and may be associated with daytime sleepiness. This study investigated the age and sex of patients with malocclusion who are at increased risk of EDS and collected data for future EDS screening. Methods: We analyzed 556 patients with malocclusion aged 6–29 years to identify age- and sex-specific differences in the risk of EDS. Adults were surveyed using the Epworth Sleepiness Scale (ESS), and non-adults were surveyed using the Epworth Sleepiness Scale for Children and Adolescents. Results: The mean ESS score was 4.1 ± 4.1, and the median score was 3. The mean score tended to increase significantly with age. In adolescents, ESS scores increased gradually. In adolescents and young adults, ESS scores were significantly higher in females than in males, and the prevalence of EDS in young adults was 16.7% in men and 32.1% in women, with a marked sex-related difference. Conclusions: In patients with malocclusion, daytime sleepiness may gradually increase from adolescence to young adulthood and be more pronounced in females. The prevalence of EDS in young adults seems higher in women than in men. Our findings could aid in the early identification of EDS and facilitate multidisciplinary cooperation between dentists and sleep specialists. Early identification of sleep problems and prompt intervention during the high-risk period for developing EDS could improve the quality of life for many adolescents and contribute to improved public health.