Sleep Disordered Breathing and Obstructive Sleep Apnea in the Cleft Population

Abstract

There is a high incidence of SDB and definable OSA in the cleft population. Though there is a statistically significant improvement after intervention, some were not cured. Sleep disturbance and OSA is likely under-reported and treated in the cleft population. PSG should be done more frequently, and post intervention PSG should be strongly considered.

Incidence of positive screening for obstructive sleep apnea in patients with isolated cleft lip and/or palate

“…Thus, relative to their unaffected peers, children with CL/P may be seven times more likely to develop OSA symptoms (1-3). Our findings are consistent with the well-documented under-recognition of OSA in children with clefts (13,14). Because pediatric OSA is linked to delays in growth (4), neurodevelopment (15) and adverse metabolic effects (16), it is plausible that delayed recognition of OSA is responsible for increased morbidity in children with CL/P.…”

Cleft Palate Repair and Velopharyngeal Dysfunction

“…Studies have estimated the risk of obstructive sleep apnea in the cleft lip-cleft palate population to range from 8.5 to 65 percent. [48][49][50] The rate of occurrence of iatrogenic obstructive sleep apnea from pharyngeal speech surgery is low and reported at two of 104 patients who underwent tailored pharyngeal flaps 51 and eight of 58 patients who underwent sphincter pharyngoplasty 51,52 (Reference 51 Level of Evidence: Therapeutic, IV). Patients with Pierre Robin sequence and/or a history of perinatal respiratory difficulties may be at highest risk.…”

Screening for Obstructive Sleep Apnea in Preschool Children with Cleft Palate

“…It is possible that a delay in recognition of this disorder in infants and children with CL/P could be responsible for increasing the morbidity associated with this malformation. Two recent reports provide evidence to support underrecognition of OSA in children with cleft (MacLean et al, 2008;Muntz et al, 2008).…”