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Prevalence and severity of obstructive sleep apnea and snoring in infants with Pierre Robin sequence

Iee Ching W Anderson, Ahmad R Sedaghat, Brian M McGinley

    The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
    |September 7, 2010
    PubMed

    Insights

    Obstructive sleep apnea (OSA) is highly prevalent in infants with Pierre Robin sequence, with 85% diagnosed before intervention. Prompt polysomnography is recommended, as snoring does not reliably indicate OSA in this population.

    Area of Science:

    • Pediatric Pulmonology
    • Sleep Medicine
    • Craniofacial Anomalies

    Background:

    • Pierre Robin sequence is a congenital condition characterized by micrognathia, glossoptosis, and cleft palate.
    • Airway obstruction is a common complication in infants with Pierre Robin sequence, often necessitating early intervention.
    • Obstructive sleep apnea (OSA) is a significant concern in this population, but its prevalence and associated symptoms require further elucidation.

    Purpose of the Study:

    • To determine the prevalence and severity of obstructive sleep apnea (OSA) in infants diagnosed with Pierre Robin sequence.
    • To assess the correlation between snoring and the presence of OSA in this specific pediatric cohort.
    • To inform clinical practice regarding the necessity of polysomnography in infants with Pierre Robin sequence.

    Main Methods:

    • Retrospective case series conducted at an urban tertiary care teaching hospital.
    • Analysis of polysomnography results from infants with Pierre Robin sequence within their first year of life (2002-2007).
    • Inclusion of initial polysomnography data only; a subgroup of prospectively tested patients was also evaluated.

    Main Results:

    • Out of 33 identified infants, 13 underwent polysomnography, with 85% (11/13) diagnosed with OSA.
    • The mean apnea-hypopnea index was 33.5, with 55% of OSA cases classified as severe.
    • Elevated end-tidal Pco2 (mean 59 mm Hg) and decreased oxygen saturation nadir (mean 80%) were observed; snoring was present in 55% of infants with OSA.

    Conclusions:

    • The high incidence of OSA in infants with Pierre Robin sequence underscores the importance of early polysomnography.
    • Snoring, while common, is not a definitive indicator of OSA, as it was absent in some affected infants.
    • Prompt polysomnography is crucial for timely diagnosis and management of OSA in children with Pierre Robin sequence.
    Abstract

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