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Does Sleep Position Influence Sleep-Disordered Breathing in Infants With Cleft Palate: A Feasibility Study?

Clare S Murray1,2, Tanya Walsh3, Trisha Bannister4

  • 1Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|April 1, 2021
PubMed

Insights

Investigating sleep position in infants with cleft palate (CP) is crucial for managing sleep-disordered breathing (SDB). This study found oxygen saturation monitoring feasible, suggesting different sleep positions may impact SDB, warranting further research.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Craniofacial Anomalies

Background:

  • Cleft palate (CP) can lead to breathing difficulties and sleep-disordered breathing (SDB) in infants.
  • The optimal sleep position for infants with CP to mitigate SDB is currently unknown.
  • Sleep position is a modifiable factor that may influence SDB severity.

Purpose of the Study:

  • To design a pragmatic study investigating the effect of two routinely advised sleep positions (supine vs. side-lying) in infants with CP on oxygen saturations.
  • To assess the feasibility and acceptability of home monitoring of oxygen saturation (SpO2) and end-tidal carbon dioxide (ETCO2) in this population.
  • To gather preliminary data to inform a future randomized controlled trial.

Main Methods:

  • A multicentered observational cohort study was conducted across four UK cleft centers.
  • Infants with isolated CP were recruited and monitored at 1 and 3 months of age.
  • Home monitoring included SpO2 and ETCO2, supplemented by qualitative parent interviews.

Main Results:

  • Oxygen saturation (SpO2) monitoring was feasible, with sufficient recordings obtained in 24 infants (13 side-lying) at 1 month and 19 infants (10 side-lying) at 3 months.
  • End-tidal carbon dioxide (ETCO2) monitoring proved challenging, with limited successful recordings and reported unacceptability by parents.
  • Parents emphasized the importance of sleep position management for infants with CP.

Conclusions:

  • Domiciliary SpO2 monitoring is feasible in infants with CP within a research setting.
  • Preliminary findings suggest potential differences in SpO2 based on sleep position, meriting further investigation.
  • A randomized study comparing side-lying and supine sleep positions is recommended to better understand SDB in infants with CP.
Abstract

Keywords:
cleft palateinfant sleep positionoxygen saturationsleep-disordered breathing

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