Background: This preliminary case series aimed to evaluate the clinical and morphometric outcomes of maxillomandibular advancement (MMA) surgery in patients with severe obstructive sleep apnea (OSA) using virtual surgical planning (VSP), patient-specific cutting guides, and customized titanium plates. Primary outcomes included changes in the Apnea–Hypopnea Index (AHI), airway dimensions, surgical accuracy, and quality of life. Methods: In this preliminary case series, six patients with severe OSA underwent MMA surgery planned using three-dimensional VSP, and executed with the aid of CAD-/CAM-generated surgical guides and patient-specific osteosynthesis. Clinical variables included AHI, Epworth Sleepiness Scale (ESS), and computed tomography-based airway morphometry. Surgical accuracy was assessed by comparing planned and achieved skeletal movements. Statistical analysis was performed using Wilcoxon signed-rank tests and Spearman’s correlation. Results: The mean preoperative AHI decreased significantly from 48.8 ± 23.6 to 12.4 ± 10.0 (p = 0.035), and ESS scores improved from 14.5 ± 4.6 to 7.8 ± 2.1 (p = 0.029). Mean airway area increased significantly from 51.8 ± 9.0 mm² to 91.8 ± 26.6 mm² (p = 0.035). A strong but non-significant correlation was observed between airway gain and ESS improvement (p = 0.754, p = 0.084). No patients required CPAP at 6-month follow-up, and all were asymptomatic. The anteroposterior accuracy of skeletal movements was high: 82.6% for the maxilla and 85.8% for the pogonion, with mean absolute errors of 1.25 mm and 1.95 mm, respectively. Vertical accuracy was lower, particularly in the chin region, where error analysis showed greater variability. No statistically significant differences were found between planned and achieved movements in any vector. Conclusions: MMA surgery performed with VSP, cutting guides, and customized titanium plates offers a highly effective, safe, and precise treatment modality for selected OSA patients. This approach leads to a significant reduction in AHI, expansion of the upper airway, and improvement in patient-reported daytime functioning. High accuracy in skeletal repositioning—particularly in anteroposterior vectors—supports the reliability and reproducibility of digitally guided orthognathic surgery. These findings reinforce the role of technologically assisted MMA as a definitive treatment for severe OSA.

Obstructive sleep apnoea syndrome (OSAS) affects between 1% and 6% of children. Its diagnosis includes: a) snoring and/or apnoea; and b) an apnoea and hypopnoea index >3/hour obtained by polysomnography (PSG). The main aim of this work is to determine the prevalence of OSAS in our study population. We conducted a descriptive study with a sample of 151 children aged between 1 and 12 years, who had been referred to the sleep unit of the Hospital General Universitario Gregorio Maranon for a PSG. We analysed the demographic variables sex and age; the clinical variables snoring, apnoeas and tonsillar hypertrophy; and the presence of OSAS based on the polysomnographic diagnostic criterion of an apnoea and hypopnoea index >3/hour. The mean age of the sample was 5.37 years (standard deviation: 3.05) and 64.9% were males. In 90.1% of cases, the reason for the visit was suspected OSAS. Snoring, apnoeas and tonsillar hypertrophy were observed in 73.5, 48.7 and 60% of cases, respectively. OSAS was diagnosed en 19 children (12.6%); in 13.5% of snorers; in 15.1% of those with apnoeas; and in 15.6% of the children with tonsillar hypertrophy. In our study, the prevalence of OSAS in children was 12.6%, which is higher than that reported in most epidemiological studies that include PSG for the diagnosis of OSAS.

The age of onset of narcolepsy ranges from childhood to the fourth decade of life, with onset after 50s being rare. Onset at an advanced age is one of the factors involved in the delay in diagnosis. On the other hand, excessive daytime sleepiness, the cardinal and most frequent symptom, is common to many other conditions, contributing to the underdiagnosis of this disorder. We present the case of a patient in the 80s with the onset of typical symptoms of narcolepsy type 1. Some comorbidities frequently associated with narcolepsy were also identified, such as obstructive sleep apnoea, restless legs syndrome and periodic limb movement disorder.

Excessive daytime sleepiness (EDS), with or without an excessive need for sleep, is a primary reason for patients seeking consultation at the sleep unit. EDS is observed in ~5% of the general population. Common causes of EDS include obstructive sleep apnea, sleep deprivation, effects of medication, psychiatric disease (especially depression), and circadian rhythm disorders. Coronavirus disease 2019 (COVID-19) infection is a rare cause of EDS. We present a case of mild COVID-19 infection as an unusual cause of hypersomnolence.

We present a case of sleep-related facio-mandibular myoclonus (FMM) in a man in the third decade of life with recurrent tongue-biting episodes during sleep onset. Video-polysomnography and video-electroencephalogram revealed myoclonic jaw jerks without epileptiform activity. The episodes were associated with stress and improved with clonazepam and non-pharmacological interventions. This case highlights sleep-related FMM as a rare, under-recognised cause of sleep-related tongue biting, distinct from epilepsy and bruxism. Early diagnosis through neurophysiological studies is crucial to prevent misdiagnosis and ensure accurate treatment.