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Published on: December 6, 2016
Management and outcomes of obstructive sleep apnea in children with Robin sequence, a cross-sectional study
Manouk J S van Lieshout1,2, Koen F M Joosten3,4, Maarten J Koudstaal5,3
1Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, Sophia Children's Hospital, Room D-210,, 3000 CA, Rotterdam,, The Netherlands. m.vanlieshout@erasmusmc.nl.
Insights
Children with Robin sequence needing respiratory support require ongoing monitoring for obstructive sleep apnea (OSA) until adulthood. Those treated with prone positioning alone are less likely to develop later airway issues.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Craniofacial Anomalies
Background:
- Obstructive sleep apnea (OSA) is a significant concern in children with Robin sequence (RS).
- Understanding the prevalence and course of OSA in RS is crucial for timely intervention.
- Early management strategies may influence long-term respiratory outcomes.
Purpose of the Study:
- To determine the prevalence and course of obstructive sleep apnea (OSA) in children with Robin sequence (RS) aged 1-18 years.
- To evaluate the management of OSA in this pediatric population.
- To identify risk factors for persistent or developing OSA in children with RS.
Main Methods:
- Cross-sectional study involving 63 children aged 1-18 years with RS.
- Data collection on baseline characteristics and management strategies.
- Polysomnography used for OSA evaluation.
Main Results:
- Respiratory support was more frequently needed in non-isolated RS cases (p < 0.05).
- In the prone positioning group (n=32), only one child had OSA.
- In the respiratory support group (n=31), 42% had respiratory problems, with 10 requiring ongoing support.
Conclusions:
- Nearly 25% of children with RS experience respiratory problems between ages 1 and 18.
- Children with RS managed with prone positioning as infants are unlikely to develop later obstructive airway issues.
- Children requiring early respiratory support are at higher risk for persistent or recurrent OSA beyond age 1.
Objective:
The objective of this cross-sectional study is to assess the prevalence, course, and management of obstructive sleep apnea (OSA) in children with Robin sequence (RS) aged 1-18 years.
Materials And Methods:
A cross-sectional study was conducted in 63 children aged 1 to18 years with RS. Patient data were collected on baseline characteristics and management. OSA was evaluated by polysomnography.
Results:
Sixty-three children with RS were included (median age 8.0 years) and divided into two groups based on the initial treatment: prone positioning or respiratory support. Respiratory support was more often indicated in children with a non-isolated RS (p < 0.05). At cross section, in the prone positioning group (n = 32), one child was diagnosed with OSA. In the respiratory support group (n = 31), 13 children (42 %) had respiratory problems of whom 10 needed respiratory support.
Conclusions:
Between the age of 1 and 18 years, almost one out of four children with RS still has respiratory problems. Children with RS, who can be treated with prone positioning only as an infant, are not likely to develop obstructive airway problems at a later age. In contrast, children who need respiratory support early after birth are at risk of continuing or re-developing OSA after the age of 1 year.
Clinical Relevance:
This study shows that those who need respiratory support at an early age need careful monitoring until adulthood.
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