Document Detail


The spectrum of sleep-disordered breathing symptoms and respiratory events in infants with cleft lip and/or palate.
MedLine Citation:
PMID:  23042804     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To determine the prevalence of sleep-disordered breathing (SDB) symptoms and respiratory events during sleep in infants with cleft lip and/or palate (CL/P). DESIGN: Prospective observational study. SETTING: Cleft palate clinic, tertiary care paediatric hospital, before palate surgery. PATIENTS: Consecutive newborn infants with CL/P. MAIN OUTCOME MEASURES: Demographics, clinical history, sleep symptoms, facial measurement and polysomnography (PSG; sleep study) data. RESULTS: Fifty infants completed PSG at 2.7±2.3 months; 56% were male, and 30% had a clinical diagnosis of Pierre Robin sequence (PRS) or a syndrome. The majority of infants (75%) were reported to snore frequently or constantly, while 74% were reported to have heavy or loud breathing during sleep. The frequency of parent-reported difficulty with breathing during sleep was 10% for infants with isolated CL/P, 33% for those with syndrome, and 43% for PRS (χ(2) 16.1, p<0.05). All infants had an Obstructive-Mixed Apnoea-Hypopnoea Index (OMAHI) >1 event/h, and 75% had an OMAHI >3 events/h. Infants with PRS had higher OMAHI (34.3±5.1) than infants with isolated CL/P (7.6±1.2) or infants with syndromes (15.6±5.7, F stat, p<0.001). Multivariate analysis showed that PRS was associated with higher OMAHI (B 0.53±0.22, p=0.022), but the majority of the variance for SDB was unexplained (constant B 1.31±0.55, p=0.024). CONCLUSIONS: The results highlight that infants across the spectrum of CL/P have a high risk of SDB symptoms and obstructive respiratory events before palate surgery. Clinicians should enquire about symptoms of SDB and consider investigation with polysomnography in all infants with CL/P.
Authors:
Joanna E Maclean; David Fitzsimons; Dominic A Fitzgerald; Karen A Waters
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-6
Journal Detail:
Title:  Archives of disease in childhood     Volume:  -     ISSN:  1468-2044     ISO Abbreviation:  Arch. Dis. Child.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372434     Medline TA:  Arch Dis Child     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Respiratory Medicine, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
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