Premium
The identification of children with cleft palate and sleep disordered breathing using a referral system
Author(s) -
MacLean J.E.,
Fitzsimons D.,
Hayward P.,
Waters K.A.,
Fitzgerald D.A.
Publication year - 2008
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20763
Subject(s) - medicine , palatoplasty , cohort study , referral , prospective cohort study , pediatrics , cohort , population , retrospective cohort study , sleep study , dentistry , polysomnography , apnea , surgery , environmental health , family medicine
Background Cleft palate is associated with an increased risk of sleep disordered breathing (SDB) but the magnitude of this risk and specific risk factors are unclear. A better understanding of these components of risk will aid the early identification of SDB in this group of children. Objective To describe the clinical characteristics and results of sleep studies undertaken in a cohort of children with cleft palate. Clinical features will be examined to determine potential associations with SDB in this group. Method A retrospective chart review was undertaken to ascertain sleep study results and clinical data for all children with cleft palate. Clinical features of interest included age, gender, syndrome diagnosis, cleft classification, and surgical status. Results A total of 99 sleep studies were available from 62 children. The sample included a select group of children with cleft palate with features predictive of a high risk of SDB. Baseline sleep study results were consistent with SDB for 87% of children and 28% (15 of 54) of these children demonstrated severe SDB. Uni‐variate analysis showed that age, syndrome, and surgical status had significant association with the severity of SDB. On multi‐variate analysis only surgical status maintained this association, such that pre‐palatoplasty/pharyngoplasty was associated with more severe SDB. Follow‐up studies were completed in one‐third of the cohort. Conclusion Children with cleft palate appear to have a significant risk of SDB. A prospective study of a population of children with cleft palate is needed to further define the characteristics of this risk and important risk factors. Pediatr Pulmonol. 2008; 43:245–250. © 2008 Wiley‐Liss, Inc.