Obstructive sleep apnea in children with cleft lip and/or palate: Results of an epidemiologic study

Introduction: Children with cleft lip and/or palate are at increased risk of obstructive sleep apnea. The prevalence of obstructive sleep apnea in this population is unknown. The purpose of this study was to assess the frequency of obstructive symptoms and obstructive sleep apnea diagnosis in the cleft population. We hypothesized that obstructive symptoms present more frequently in children with orofacial clefts than unaffected children, and that frequency varies by cleft sub-type. Methods: Children with isolated cleft lip and/or palate and children without birth defects born 1997-2003 were identified through the North Carolina Birth Defects Monitoring Program and birth records, respectively. A survey assessed airway obstructive symptoms, clinical diagnosis of obstructive sleep apnea, and prior polysomnography. Results were analyzed by frequency distributions and chi-square statistics. Results: Obstructive symptoms were reported more frequently in cleft palate and cleft lip with palate than in cleft lip and unaffected children. Trouble sleeping and nighttime mouth breathing were reported in up to 37.9% of cleft palate and 45.5% of cleft lip and palate (p<0.05). There was no statistically significant difference between cleft lip and unaffected children. Obstructive sleep apnea was diagnosed in 6.3% of children with clefts and 0% of unaffected children (p<0.0001). Conclusions: This study demonstrates a high frequency of obstructive symptoms in patients with cleft palate and cleft lip and palate. More children presented with obstructive symptoms than were diagnosed with obstructive sleep apnea. These children should be monitored for obstructive sleep apnea with a low threshold for polysomnography. Correspondence to: Eileen Raynor, Division of Otolaryngology Head and Neck Surgery & Communication Sciences, Duke Children’s Hospital; Durham, NC, USA, E-mail: [email protected]