Open AccessDoes Sleep Position Influence Sleep-Disordered Breathing in Infants With Cleft Palate: A Feasibility Study?
Author(s) -
Clare Murray,
Tanya Walsh,
Trisha Bannister,
Aleksandra Metryka,
Karen Davies,
Yin-Ling Lin,
Paula Williamson,
Peter Callery,
Kevin O’Brien,
William Fletcher Shaw,
Iain Bruce
Publication year - 2021
Publication title -
the cleft palate-craniofacial journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.641
H-Index - 79
eISSN - 1545-1569
pISSN - 1055-6656
DOI - 10.1177/10556656211003459
Subject(s) - supine position , medicine , sleep disordered breathing , breathing , oxygen saturation , pediatrics , anesthesia , psychological intervention , sleep (system call) , affect (linguistics) , observational study , physical therapy , psychology , oxygen , psychiatry , obstructive sleep apnea , computer science , operating system , chemistry , organic chemistry , communication
Objective: Cleft palate (CP) can affect breathing, leading to sleep-disordered breathing (SDB). Sleep position can affect SDB, but the optimum sleep position for infants with CP is unknown. We aimed to determine the design of a pragmatic study to investigate the effect of the 2 routinely advised sleep positions in infants with CP on oxygen saturations.Design: A multicentered observational cohort.Setting: Four UK-based cleft centers, 2 advising supine- and 2 side-lying sleep positions for infants with CP.Participants: Infants with isolated CP born July 1, 2015, and December 31, 2016. Of 48 eligible infants, 30 consented (17 side-lying; 13 supine).Interventions: Oxygen saturation (SpO 2 ) and end-tidal carbon dioxide (ETCO 2 ) home monitoring at age 1 and 3 months. Qualitative interviews of parents.Outcome Measures: Willingness to participate, recruitment, retention, and acceptability/success (>90 minutes recording) of SpO 2 and ETCO 2 monitoring.Results: SpO 2 recordings were obtained during 50 sleep sessions on 24 babies (13 side-lying) at 1 month (34 sessions >90 minutes) and 50 sessions on 19 babies (10 side-lying) at 3 months (27 sessions >90 minutes). The ETCO 2 monitoring was only achieved in 12 sessions at 1 month and 6 at 3 months; only 1 was >90 minutes long. The ETCO 2 monitoring was reported by the majority as unacceptable. Parents consistently reported the topic of sleep position in CP to be of importance.Conclusions: This study has demonstrated that it is feasible to perform domiciliary oxygen saturation studies in a research setting and has suggested that there may be a difference in the effects of sleep position that requires further investigation. We propose a study with randomization is indicated, comparing side-lying with supine-lying sleep position, representing an important step toward better understanding of SDB in infants with CP.