The effect of cleft palate repair on polysomnography results

Bergeron, Mathieu; Duggins, Angela; Pan, Brian S.; Babiker, Haithem Elhadi; Ishman, Stacey L.

doi:10.1016/j.sleep.2017.11.087

Cited by 3 publications

(3 citation statements)

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“…Previous economic discussions pertaining to OSA have focused on the cost of PSG and advocated for lowering the costs of diagnostic testing in the United States. [19][20][21][22][23][24][25] While this factor was not investigated in our study, factors such as more affordable diagnostic testing and its thoughtful utilization would be potential solutions to reduce the costs associated with persistent OSA.…”

Section: Discussionmentioning

confidence: 99%

Persistent Obstructive Sleep Apnea Burden on Family Finances and Quality of Life

Bergeron

Ishman

2021

Otolaryngol.--head neck surg.

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Objective We previously found that financial concerns negatively affect the quality of life of families of children with persistent obstructive sleep apnea (OSA) after tonsillectomy. The goal is to quantify the financial impact on families of children with persistent OSA and assess contributing factors. Study Design Cross-sectional survey study with comparison group. Setting Upper airway center at a tertiary pediatric hospital. Methods Participants included consecutive children with persistent OSA from September to October 2017. Healthy children seen in a general otolaryngology clinic served as controls. Families of both groups completed the Family Impact Questionnaire and the modified Comprehensive Score for Financial Toxicity (COST). Results Families of the 50 patients (25 study and 25 control) completed the surveys: the mean age was 6.4 years (95% CI, 5.0-7.8), and 19 (38%) were female. There were no differences in age, sex, race, or insurance status between groups ( P > .05). The mean apnea-hypopnea index for the study group was 7.9 events/h (range, 5.5-10.3), and 40% (10/25) had Down syndrome. Positive airway pressure and/or oxygen were used by 72% (18/25). The Comprehensive Score for Financial Toxicity for study patients (21.9; 95% CI, 14.8-26.0) was significantly lower than for controls (30.2; 95% CI, 26.6-30.8; P = .003), reflecting elevated financial toxicity. Study families reported greater financial impact on the Family Impact Questionnaire (8.4; 95% CI, 6.1-10.7) versus controls (3.6; 95% CI, 1.8-5.4; P = .002); concerns regarding missed days of work and school were common (30.7%). Conclusion Families of children with persistent OSA reported a high financial burden related to their children’s disease and were more likely to report financial toxicity than families of controls. Concern regarding missed work and school associated with appointments and treatment was a significant factor.

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Section: Discussionmentioning

confidence: 99%

Persistent Obstructive Sleep Apnea Burden on Family Finances and Quality of Life

Bergeron

Ishman

2021

Otolaryngol.--head neck surg.

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“…Similarly, only a small number of patients in our investigation did not have overt CP; thus, a robust comparison of OSA indexes to those with CP could not be performed. With larger numbers, differences in OSA indexes may have been identified, as some studies have suggested that airway physiology may be different in these patients with CP versus those without CP or repaired CP (Bergeron et al, 2019; Greenlee et al, 2019). Finally, patients with RS are a heterogeneous population, with numerous potential confounders such as associated cardiopulmonary disorders, CNS anomalies, and other syndromic findings.…”

Section: Discussionmentioning

confidence: 99%

Defining Age-related OSA Features in Robin Sequence Using Polysomnographic-based Analyses of Respiratory Arousal Responses and Gas-exchange Parameters

Niño

Aziz

Weiss

et al. 2021

The Cleft Palate Craniofacial Journal

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Introduction Robin sequence (RS) is a leading cause of obstructive sleep apnea (OSA) in newborns. Most studies have focused on understanding anatomic factors leading to OSA and changes in apnea–hypopnea index (AHI) on polysomnography (PSG) beyond the neonatal period. This study aims to define age-related OSA features between patients with RS, without RS and healthy controls using PSG-based analyses of respiratory arousal responses and gas-exchange parameters. Design Retrospective comparison of PSG features in a total of 48 children encompassing three groups: (a) infants with RS (n = 24, <1-year old), (b) non-RS older children (1-2 years old) with severe OSA (obstructive AHI (OAHI) of ≥10 events; n = 12), and (c) control infants and children (0-2 years old) without sleep apnea (OAHI ≤1.5/h, n = 12). We examined OSA sleep-stage specific and position-specific indexes, and the relationship between OSA severity and respiratory arousal indexes (OAHI/respiratory arousal indexes). Results OSA sleep-stage specific indexes (rapid eye movement [REM] vs non-REM[NREM]) as well as position-specific indexes (supine vs nonsupine) were similar in individuals with and without RS. Relative to the non-RS groups, infants with RS have more sustained hypoxemia (time with SpO2 < 90%) and reduced arousal responses to OSA demonstrated by higher OAHI/respiratory arousal indexes. OAHI/respiratory arousal indexes significantly correlated with the severity of hypoxemia in infants with RS. Conclusion Infants with RS and OSA show reduced arousal responses to apneic events, which correlates with higher hypoxemia severity. OAHI/respiratory arousal indexes in RS may identify high-risk individuals with upper airway obstruction and reduced arousal protective responses.

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“…In a recent study, Bergeron and his colleagues have found that primary palatoplasty did not cause or worsen OSA in most cases. In 20% of their patients, some worsening occurred and the presence of an associated syndrome was the only predictive factor (Bergeron et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Furlow Palatoplasty, Nasopharyngeal Size, and Sleep Oximetry

Gilbert

Leclerc

Deschênes

et al. 2020

The Cleft Palate Craniofacial Journal

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Objectives: (1) To assess the evolution of prepalatoplasty sleep oximetry (PRESO) and postpalatoplasty sleep oximetry (POSSO) in cleft patients and (2) to evaluate the impact of the size of the nasopharynx on PRESO and POSSO values. Study Design: Retrospective cohort study. Patients and Methods: In 81 patients with cleft palate and/or cleft lip, the following data were prospectively collected: patient demographics and prepalatoplasty cleft palate measurements. All the patients had at least 1 PRESO and POSSO. A Kaplan-Meier curve was obtained from all the sleep oximetry results. Transverse nasopharyngeal area (TNA) pre- and postvalues were compared for each group with paired t tests, while analysis of variance was used to compare TNA pre- and postscores between the groups with a Bonferroni correction for multiple comparisons. Results: POSSO results were normal or showed mild desaturations in most patients in the few weeks following palatoplasty. For the cohort, no statistically significant changes were found between PRESO and POSSO values. A 2-fold variation in the area of the TNA was found before palatoplasty within identical cleft malformation cases. No statistically significant association was found between the TNA or the a/30 − b 1 parameter values and the sleep study scores. Conclusions: The patients with the smaller nasopharyngeal areas presented identical PRESO and POSSO results when compared to those with larger nasopharyngeal sizes. Future studies should address the possible association between prepalatoplasty and postpalatoplasty TNAs and the occurrence of velopharyngeal deficiency later in life.

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The effect of cleft palate repair on polysomnography results

Cited by 3 publications

References 0 publications

Persistent Obstructive Sleep Apnea Burden on Family Finances and Quality of Life

Persistent Obstructive Sleep Apnea Burden on Family Finances and Quality of Life

Defining Age-related OSA Features in Robin Sequence Using Polysomnographic-based Analyses of Respiratory Arousal Responses and Gas-exchange Parameters

Furlow Palatoplasty, Nasopharyngeal Size, and Sleep Oximetry

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