This article seeks to evaluate the 3D volumetric changes that are necessary to treat pediatric Obstructive Sleep Apnea (OSA). Adult static therapies are not indicated for children. Children require dynamic therapies to encourage and correct skeletal development to improve sleep-breathing disorders. Formulas for arch width expansion are currently based on dental space and skeletal calculations and are not applicable nor are they validated in the treatment of pediatric OSA. Treating children with OSA requires a new formula of skeletal development for both maxilla and mandible based on correction of the immediate medical problem evaluated by overnight sleep testing called polysomnography (PSG) (attended) or home sleep testing (HST) (unattended).