Related Experiment Video
Updated: May 18, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Management of sleep apnea in the cleft population
1Division of Otolaryngology-Head and Neck Surgery, Primary Children's Medical Center, University of Utah, Salt Lake City, Utah, USA. harlan.muntz@imail.org
Purpose Of Review:
Obstructive sleep apnea is prevalent in children with facial clefts. As there are increasing concerns that sleep disordered breathing and obstructive sleep apnea may lead to cognitive difficulties, it is imperative that the otolaryngologist and cleft surgeon be aware of the concerns for sleep disorders and implement appropriate interventions for the management.
Recent Findings:
Micrognathia associated with Robin Sequence has long been understood to have significant potential for sleep apnea. Positioning, nasopharyngeal airway, tongue-lip adhesion and mandibular distraction have been used to improve the breathing in this set of children. Screened by symptoms, a large proportion of children with clefts will have a positive sleep study. Syndromic children seem to be more prone to this, even though nonsyndromic children are also at risk. Children who have had secondary management of velopharyngeal insufficiency with pharyngeal flap and sphincter pharyngoplasty seem to be at greater risk of sleep disorder. Specific directed therapies should provide the optimum results for the correction including tonsillectomy with partial adenoidectomy, revision pharyngoplasty, maxillary advancement and continuous positive airway pressure for sleep.
Summary:
Awareness of the risk of sleep disorders and the possible treatments in children with cleft deformities is very important for the otolaryngologist.
Related Concept Videos
Sleep Apnea
The condition is more prevalent among...
Cardiopulmonary Resuscitation II: ACLS Airway Management
Cystic Fibrosis: Management
Sinus disease and chronic sinusitis...
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation (NIPPV)
Suctioning the Nasopharyngeal Airway
Equipment Required

