

































 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                                           Rakotoson M1* * 

https://ijojournals.com/                                                                               Volume 08 || Issue 03 || March, 2025 || 

“ ORTHODONTIC TYPOLOGY OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN MAHAJANGA, MADAGASCAR." 

 

 

ORTHODONTIC TYPOLOGY OF OBSTRUCTIVE SLEEP APNEA 

SYNDROME IN MAHAJANGA, MADAGASCAR 

 

Rakotoson M1,2*, Randrianandraina MP3,4, Ralaizafindraibe TH3,6,Raotoson H2,3, 

Rakotoarison KKA2, Randrianarimanarivo HM1 

 

1Department of Orthodontics, Institute of Tropical Odonto-Stomatology of Madagascar 
(IOSTM) ; Madagascar 

2Department of Maxillofacial Surgery,  Hospital Professor ZAFISAONA Gabriel,Madagascar 

3Faculty of MedicineMahajanga; Madagascar 

4Department of Otorhinolaryngology (ENT), Hospital Professor ZAFISAONA 
Gabriel,Madagascar 

5Department of ThoracicSurgery, Hospital Professor ZAFISAONA Gabriel, Madagascar 

 

Correspondingauthor : RAKOTOSON Mariette 

Department of Orthodontics, Institute of Tropical Odonto-Stomatology of Madagascar 
(IOSTM) ; Madagascar 

 

ABSTRACT 

Purpose:The aim of ourstudywas to describe the orthodontictypology of studentswith OSA in 

Mahajanga Madagascar. 

Material and methods:This is a cross-sectional descriptive study on a student population of 

the University of Mahajanga Madagascar on World Health Day in 2024 at the university 

campus. Sampling wasconducted in simple randomness. The data wasanalyzed on the SPPSS 

25.0 software. 

Results:The surveyidentified 120 studentswith a sex ratio of 0.84. The averageagewas 22 

years. The prevalence of OSA was 11.6%. The classification of the shift of the bony bases 

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 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                                           Rakotoson M1* * 

https://ijojournals.com/                                                                               Volume 08 || Issue 03 || March, 2025 || 

“ ORTHODONTIC TYPOLOGY OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN MAHAJANGA, MADAGASCAR." 

 

 

wasdominated by Class I at 50% of studentswhohad OSA.  The exooralexamination of the 

profile in the sagittal direction evaluated a convex profile at 85.7%. 

Conclusion: OSA is a seriousunderdiagnosedpathology in Madagascar. The 

decliningintellectuallevel of studentscould have something to do withtheirhiddenhealth 

situation. Dentofacial Orthopedicsparticipates in the screening of thispathology in order to 

improve the health of the population in our country. 

 

Key words:Obstructive sleepapnea, Madagascar, Dentofacial orthopedics. 

 

1. Introduction 

Obstructive sleepapnoea syndrome (OSA) isdefined by the occurrence of 

abnormallyfrequentepisodes of complete or partial obstruction of the upperairwayduringsleep, 

resulting in total interruption (apnea) or significantreductions (hypopnea) in ventilation [1]. 

Obstructive sleepapnea-hypopnea syndrome (OSAHS) isfeared, in addition to the 

cardiovascular complications it can induce or increase, for chronic fatigue, excessive 

daytimesleepiness, but also for the difficulties in concentration and attention to whichit 

exposes [2]. The literaturereview reports the prevalence of OSA in the general population in 

the order of 4 to 5% of men and 2% of women [3].Sleepdisorders are extremelycommon (40-

86%) in children and adolescents [4]. Obstructive SleepApnea Syndrome (OSA) can have an 

impact on attention and learningskills. The student population 

maybeconfrontedwiththispathologywhich can alter itsability to assimilate.  The objective of 

ourstudywas to describe the orthodontictypology of studentswith OSA in Mahajanga 

Madagascar. 

 

 

2. Materials and methods 

This is a cross-sectional descriptive study. The studyiscarried out on a student population of 

the University of Mahajanga Madagascar during the UniversityHealth Week dedicated to 

World Health Day in April 2024 at the university campus. Sampling wasconducted in simple 

IJO JOURNALS

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 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                                           Rakotoson M1* * 

https://ijojournals.com/                                                                               Volume 08 || Issue 03 || March, 2025 || 

“ ORTHODONTIC TYPOLOGY OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN MAHAJANGA, MADAGASCAR." 

 

 

randomness.The data collectedwereenteredinto an electronicsurveyformusing the Access® 

software version 2007. The data wasanalyzed on the SPPSS 25.0 software. Eachstudent's 

consent wasobtainedprior to their inclusion in the study and recalledprior to the start of the 

exam. The purpose of the study and all stages of the reviewwereexplainedorally. The 

confidentiality of information, humanrights, the rights to freedom of opinion, 

professionalsecrecy and privacy have been respected. 

 

 

3. Results 

The surveyidentified 120 studentswith a sex ratio of 0.84. The averageagewas 22 years.  

Table 1 : Gender distribution 

Gender Number Percentage 

Male 55 45,8% 

Female 65 54,2% 

Total 120 100% 

 

Table 2 : Age distribution 

Age Numbre Percentage 

18-23 yearsold 80 66,6% 

24-30 yearsold 40 33,3% 

Total 120 100% 

 

Table 3 : Distribution by gender and presence of sleepapnea(n=120) 

 Sleepapnea 

Gender Number Percentage 

Male 6 5% 

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 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                                           Rakotoson M1* * 

https://ijojournals.com/                                                                               Volume 08 || Issue 03 || March, 2025 || 

“ ORTHODONTIC TYPOLOGY OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN MAHAJANGA, MADAGASCAR." 

 

 

Female 8 6,6% 

Total 14 11,6% 

 

 

 

Table 4 : Distribution by dental class (n=120) 

 Classe dentaire 

Gender Class I Class II Class III 

Male 25 (20,8%) 18 (15%) 12 (10%) 

Female 32 (26,6%) 23 (19,1%) 10 (8,3%) 

Total 57 (47,5%) 41 (34,1%) 22 (18,3%) 

 

Table 5 : Distribution by profile (n=120) 

 Profile 

Gender Convex Concave 

Male 45 (37,5%) 10 (8,3%) 

Female 56 (46,6%) 9 (7,5%) 

Total 101 (84,1%) 19 (15,8%) 

 

 

4. Discussion  

Our study reports a higher percentage of studentswithsleepapnea in the femalegender, while 

the literature states that the riskfactors for the development of sleepapneaare:obesity, male 

gender, age, black race, alcohol and tobacco and male genderisconsidered a predisposing 

factor. The frequency of OSA ishigher in men than in women [5]. 

The literatureindicatesthatsnoringincreaseswithage and thatitisexacerbated, amongotherthings, 

by alcohol, smoking, sedatives, sleepdeprivation [6]. A studycarried out in Kinshasa in 2008 

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 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                                           Rakotoson M1* * 

https://ijojournals.com/                                                                               Volume 08 || Issue 03 || March, 2025 || 

“ ORTHODONTIC TYPOLOGY OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN MAHAJANGA, MADAGASCAR." 

 

 

reported a high percentage of subjectswith obstructive sleepapnea syndrome in groups of 

subjectsaged 25 to 35 years at 28.6% [7]. This differs in ourstudy, withstudentsaged 18 to 23 

being more numerous at 66.6%. Nevertheless, Dayyat et al. proposedin 2007 a classification 

of OSA intothree types [8].Types 1 and 2 have in common the usualrespiratorysigns (snoring, 

restlesssleep, laboredbreathing, mouthbreathing, parent-describedbreathing stoppages, 

excessive sweating) and the possible existence of parasomnias (bedwetting, night terrors, and 

nightmares). In type 1, itismainlyyoung people who are not overweight, 

withmarkedadetonsillarhypertrophy and oftenwith attention deficithyperactivitydisorders, 

whereas in type 2 the children are overweightwithvisceral and truncalobesity, an increased 

neck diameter, and lessadenotonsillarhypertrophythan in type 1,  But on the other hand, 

excessive daytimesleepiness and psychologicaldisorders (low self-esteem, depression, 

pathologicalshyness) are much more frequent, as well as cardiovascular and metabolic 

complications.Type 3 OSA occurs in subjectswithneurological, malformative or genetic 

pathologies, withcraniofacial malformations, neuromuscular or skeletalinvolvement (trisomy 

21, Prader-Willi syndrome, Pierre-Robin syndrome, achondroplasia, craniostenosis) [9]. 

The prevalence of OSA wasestimated at 3.23% [10], but ourstudyreveals a prevalence of 

11.6%. 

The standard treatmentismostoftenContinuous Positive Airway Pressure (CPAP), but also a 

Mandibular Advanced Orthosis, which have been reported by 

severalauthorsincludingRakotoson M et al in 2024 [11]. The 

MandibularAdvancementOrthosis can simultaneouslytreat a skeletal Class II, 

whichconstitutes 34.1% of ourstudy population.The convex profile makes up the majority of 

ourstudy population at 84.1%, whichcorroborates the study by Rakotoson M et al in 2023 

[12,13]. 

 

 

5. Conclusion 

OSA is a serious and underdiagnosed condition in Madagascar. The observation of excessive 

daytimesleepinessshouldbefearedbecause the decliningintellectuallevel of studentscould have 

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 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                                           Rakotoson M1* * 

https://ijojournals.com/                                                                               Volume 08 || Issue 03 || March, 2025 || 

“ ORTHODONTIC TYPOLOGY OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN MAHAJANGA, MADAGASCAR." 

 

 

a relationshipwiththeirhiddenhealth situation. Dentofacial Orthopedics or 

Orthodonticsparticipates in the screening of thispathology in order to improve the health of 

the population in our country. 

 

 

 

 

 

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 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING  
 ( ISSN: 2814-2098 )                                                                                                                           Rakotoson M1* * 

https://ijojournals.com/                                                                               Volume 08 || Issue 03 || March, 2025 || 

“ ORTHODONTIC TYPOLOGY OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN MAHAJANGA, MADAGASCAR." 

 

 

8.Dayyat E, Kheirandish-Gozal L, Gozal D. Childhood obstructive sleepapnea: one or two 

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13.Rakotoson M, Andriniaina FA, Ratsirarisoa T, Andrinjakarivony N, Rasoanirina MO, 

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