Prevalence and Risk Factors of Obstructive Sleep Apnea in Patients With Complete Cleft Lip and Palate in the Northeastern Thailand

Abstract

Objective

To evaluate the prevalence of obstructive sleep apnea (OSA) in patients with nonsyndromic unilateral complete cleft lip and palate (UCLP) and to study the associations between contributing factors and OSA.

Design

Prospective study adopting pediatric sleep questionnaire (PSQ) and portable polysomnography (PSG) in patients at high risk of OSA.

Setting

Tawanchai Cleft Center, Khon Kaen University.

Patients

Patients aged 7 to 15 years with nonsyndromic UCLP.

Main Outcome Measure

A PSQ score ≥8 was positive for OSA risk. Potential contributing factors included sex, weight for height, Friedman tongue position, tonsil grading, dental occlusion, transverse discrepancy, daytime sleepiness, quality of life, and pharyngeal airway.

Results

The study population comprised 102 participants (mean age, 9.67 years). Nine (8.8%) patients had a high risk of OSA, based on PSQ results. On PSG, 7 (77.8%) patients had mild OSA and 2 (22.2%) patients had moderate OSA. The mean respiratory event index (REI) was 3.47 ± 1.65 events/h. OSA severity and contributing factors were not correlated. The minimal cross-sectional area and total airway volume showed a moderate negative correlation, with significant alterations observed at the oropharyngeal level. Reduced dimensions correlated with increased OSA severity at the oropharyngeal level, as demonstrated by a moderate negative correlation with REI.

Conclusions

OSA risk among patients with UCLP was 8.8%. While this rate may seem moderate relative to that of the general population, it indicates that patients with UCLP have an inherent predisposition to OSA. This highlights the importance of comprehensive management, including PSQ screening, evidence-based counseling, and appropriate specialist referrals.