Objective-Children with craniofacial anomalies are at high risk of sleep-disordered breathing (SDB), yet its prevalence among children with craniofacial conditions is not known. Children with a relatively common congenital craniofacial condition, hemifacial microsomia (HFM), are likely particularly vulnerable to SDB due to underdevelopment of the mandible and oropharynx. Nevertheless, most children with HFM are not referred for sleep studies. We hypothesized that sleep outcomes would be worse in children with HFM versus controls.Methods-We conducted a follow-up study among 124 cases and 349 controls who previously participated in a study of HFM risk factors. Cases were eligible if diagnosed by a craniofacial specialist at one of 25 participating centers. Controls were matched to cases by pediatric practice and age at interview. Parents completed the Pediatric Sleep Questionnaire (PSQ) regarding symptoms of SDB and sleep habits. Regression models were adjusted for region, age, sex, race/ethnicity and maternal education.
Results-Snoring was more commonly reported for children with HFM (29%) than controls (17%)[adjusted odds ratio (adjOR)=1.9, 95% confidence interval (CI) 1.1-3.2]. Compared with controls, children with HFM more often had symptoms consistent with SDB (adjOR=2.8, CI 1.5-5.1). On average, cases' parents reported 1.9 times as many symptoms on the PSQ breathing scale (CI 1.4-2.7), and 1.3 times more symptoms on the PSQ sleepiness scale (CI 0.9-1.8) than did controls' parents, with little difference on the PSQ behavior scale. Parents of children with HFM reported 1.4 times more night awakenings than did controls' parents (CI 0.9-2.2). There was no association for sleep-onset latency or time in bed.Conclusions-Children with HFM experienced more snoring and other symptoms of SDB than controls. Pediatricians should be aware of the increased vulnerability for SDB among children with