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Sleep outcomes in children with hemifacial microsomia and controls: a follow-up study
Yona K Cloonan1, Yemiserach Kifle, Scott Davis
1Department of Epidemiology, Michigan State University, East Lansing, Michigan 48823, USA. yona@msu.edu
Insights
Children with hemifacial microsomia (HFM) experience more symptoms of sleep-disordered breathing (SDB), including snoring and night awakenings, compared to their peers. Early awareness and referral to sleep specialists are crucial for these vulnerable children.
Area of Science:
- Pediatric Sleep Medicine
- Craniofacial Anomalies
- Sleep-Disordered Breathing
Background:
- Children with craniofacial anomalies face a high risk of sleep-disordered breathing (SDB).
- Hemifacial microsomia (HFM), characterized by mandibular and oropharyngeal underdevelopment, may particularly increase SDB vulnerability.
- Most children with HFM are not referred for sleep studies, despite potential risks.
Purpose of the Study:
- To investigate the prevalence and characteristics of SDB in children with HFM.
- To compare sleep outcomes between children with HFM and healthy control subjects.
- To hypothesize that children with HFM would exhibit worse sleep outcomes.
Main Methods:
- A follow-up study involved 124 children with HFM and 349 control subjects.
- Parental surveys using the Pediatric Sleep Questionnaire (PSQ) assessed SDB symptoms and sleep habits.
- Regression models controlled for demographic and socioeconomic factors.
Main Results:
- Children with HFM reported significantly more snoring (29% vs. 17%) than controls.
- HFM cases showed more symptoms of SDB, with parents reporting 1.9 times more breathing issues and 1.3 times more sleepiness symptoms.
- Parents of children with HFM reported 1.4 times more night awakenings.
Conclusions:
- Children with HFM exhibit a higher incidence of snoring and other SDB symptoms compared to controls.
- Pediatricians should recognize the heightened SDB risk in children with mandibular or external ear anomalies.
- Referral to sleep specialists is recommended for children with HFM experiencing SDB symptoms.
Objective:
Children with craniofacial anomalies are at high risk for sleep-disordered breathing (SDB), yet its prevalence among children with craniofacial conditions is not known. Children with hemifacial microsomia (HFM) are likely particularly vulnerable to SDB as a result of underdevelopment of the mandible and oropharynx. Nevertheless, most children with HFM are not referred for sleep studies. We hypothesized that sleep outcomes would be worse in children with HFM versus control subjects.
Methods:
We conducted a follow-up study among 124 case participants and 349 control subjects who previously participated in a study of HFM risk factors. Parents completed the Pediatric Sleep Questionnaire (PSQ) regarding symptoms of SDB and sleep habits. Regression models were adjusted for region, age, sex, race/ethnicity, and maternal education.
Results:
Snoring was more commonly reported for children with HFM (29%) than for control subjects (17%). Compared with control subjects, children with HFM more often had symptoms consistent with SDB. On average, case participants' parents reported 1.9 times as many symptoms on the PSQ breathing scale and 1.3 times more symptoms on the PSQ sleepiness scale than did control subjects' parents, with little difference on the PSQ behavior scale. Parents of children with HFM reported 1.4 times more night awakenings than did control subjects' parents.
Conclusions:
Children with HFM experienced more snoring and other symptoms of SDB than did control subjects. Pediatricians should be aware of the increased vulnerability for SDB among children with mandibular or external ear underdevelopment or asymmetry and should refer to a sleep specialist as needed.
