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Purpose <p>To examine associations between vertical craniofacial growth pattern, self-reported daytime sleepiness, sleep-related complaints, and lip posture in adolescents.</p> Methods <p>This cross-sectional study included 157 adolescents aged 12–14&#xa0;years classified as hyperdivergent (<i>n</i> = 121) or normodivergent (<i>n</i> = 36). Daytime sleepiness and sleep-related complaints were assessed using an Epworth sleepiness scale (ESS)-based questionnaire and Berlin questionnaire (BQ)-derived items. Lip posture was measured cephalometrically. Independent t‑tests, chi-square/Fisher exact tests, Pearson correlations, and multiple linear regression were used.</p> Results <p>Hyperdivergent adolescents had higher ESS and BQ scores (<i>p</i> &lt; 0.001; ESS d = 0.70), more frequent sleep-disordered breathing (SDB)-related symptoms (<i>p</i> &lt; 0.05), and a&#xa0;significant Frankfort mandibular plane angle (FMA)–ESS association after adjustment for age, body mass index, and sex (β =0.354, <i>p</i> &lt; 0.001). Lip posture showed no group differences or associations with BQ, with only weak correlations with ESS or sleep duration.</p> Conclusion <p>Hyperdivergence, but not lip posture, was associated with greater questionnaire-derived sleepiness and SDB symptoms.</p>

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Hyperdivergency and lip posture in relation to self-reported sleepiness in adolescents

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月2日

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  • Mustafa Kosmen,
  • Aslihan Mediha Erdinc,
  • Ezgi Cansu Firinciogullari

摘要

Purpose

To examine associations between vertical craniofacial growth pattern, self-reported daytime sleepiness, sleep-related complaints, and lip posture in adolescents.

Methods

This cross-sectional study included 157 adolescents aged 12–14 years classified as hyperdivergent (n = 121) or normodivergent (n = 36). Daytime sleepiness and sleep-related complaints were assessed using an Epworth sleepiness scale (ESS)-based questionnaire and Berlin questionnaire (BQ)-derived items. Lip posture was measured cephalometrically. Independent t‑tests, chi-square/Fisher exact tests, Pearson correlations, and multiple linear regression were used.

Results

Hyperdivergent adolescents had higher ESS and BQ scores (p < 0.001; ESS d = 0.70), more frequent sleep-disordered breathing (SDB)-related symptoms (p < 0.05), and a significant Frankfort mandibular plane angle (FMA)–ESS association after adjustment for age, body mass index, and sex (β =0.354, p < 0.001). Lip posture showed no group differences or associations with BQ, with only weak correlations with ESS or sleep duration.

Conclusion

Hyperdivergence, but not lip posture, was associated with greater questionnaire-derived sleepiness and SDB symptoms.