{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T23:59:27Z","timestamp":1776211167268,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effect of the palatal expansion with Hyrax and Hyrax\u2009+\u2009Up\u2010Locker on sleep behavior, snoring and sleep architecture in children with Sleep Disordered Breathing (SDB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      This prospective, single\u2010blind, randomized controlled clinical trial enrolled 34 children aged 6\u20138 years. Participants were randomly assigned using a computer\u2010generated randomization process to receive treatment with either the Hyrax expansion appliance alone or in combination with the Up\u2010Locker vacuum activator. Sleep architecture was evaluated via polysomnography and sleep behavior through the Children's Sleep Habits Questionnaire (CSHQ). Data were analyzed with Shapiro\u2013Wilks for homogeneity and comparisons were performed with either\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test or Mann\u2013Whitney.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Children in the Hyrax + Up\u2010Locker exhibited superior outcomes than in the Hyrax group, including statistically significant reduction in sleep onset delay (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) and night wakings (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), as well as a notable decrease in snoring (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Children in the Hyrax\u2009+\u2009Up\u2010Locker vacuum activator group experienced more significant improvements in sleep latency, total sleep time, REM sleep, AHI in REM and nREM sleep, and arousal indices compared to the Hyrax group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) after treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined treatment with Hyrax\u2009+\u2009Up\u2010Locker vacuum activator yielded superior outcomes in sleep architecture and sleep behavior.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT06986343.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71424","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T09:16:10Z","timestamp":1768209370000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Palatal Expansion With Up\u2010Locker on Children With Sleep\u2010Disordered\u2010Breathing: A Clinical Trial"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0695-7562","authenticated-orcid":false,"given":"Claudia","family":"Restrepo","sequence":"first","affiliation":[{"name":"CES\u2010LPH Research Group Universidad CES Medell\u00edn Antioquia Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Kahn","sequence":"additional","affiliation":[{"name":"CES\u2010LPH Research Group Universidad CES Medell\u00edn Antioquia Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8195-6036","authenticated-orcid":false,"given":"David","family":"Gozal","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics, Biomedical Sciences and Office of the Dean Joan C. 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