Robin Sequence and Isolated Cleft Palate are Associated With a High Prevalence of Obstructive Sleep Apnea in School-Aged Children

Abstract

Objective

To analyze the prevalence of obstructive sleep apnea (OSA) in children aged 6 to 12 years with nonsyndromic Robin sequence (NSRS) and in those with nonsyndromic cleft palate (NSCP). All patients presented complete cleft palate (Veau II).

Design

Cross-sectional study.

Setting

Tertiary public hospital.

Patients

A total of 146 children divided into 2 groups: (1) NSRS (n = 69), (2) NSCP (n = 77).

Interventions

(1) Anthropometric assessment, dentoskeletal, and facial analysis. (2) Clinical interview with “Sleep Disturbance Scale for Children” and “Congestion Quantifier Five-Item” (CQ5); and (3) 48 patients: Type IV polysomnography.

Main Outcome Measures

Frequency of OSA in children with NSRS and NSCP, assessed by Type IV polysomnography.

Results

Positive scores for OSA were found in 59.42% of children with NSRS and 46.75% of those with NSCP (P > .05). Excessive daytime sleepiness was observed in 23.19% of the NSRS group and 9.01% of the NSCP group (P > .05). Positive scores for nasal obstruction were noted in 14.49% with NSRS and 20.78% of those with NSCP (P > .05). In polysomnography IV subgroups, an Oxygen Desaturation Index compatible with mild to moderate OSA was observed in 89.65% of the NSRS group and 78,94% of the NSCP group (P > .05). Also, facial and pharyngeal alterations, such as Angle Class II malocclusion, Mallampati classifications III and IV, and deep crossbite, were associated with OSA.

Conclusion

Both children with NSRS and NSCP have a high frequency of mild to moderate OSA, highlighting the need for systematic evaluation of the presence of sleep-disordered breathing in this population.