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Sleep and neurocognitive outcome in primary school children with Robin Sequence

Cornelia Wiechers1,2, Simone Uhlig1, Anette Poets1

  • 1Department of Neonatology, Tuebingen University Hospital, Tuebingen, Germany.

Sleep
|December 25, 2022
PubMed

Insights

Children with Robin sequence have a higher risk of obstructive sleep apnea (OSA) and behavioral issues. Early OSA treatment in infancy is linked to normal neurocognitive outcomes in primary school-aged children.

Area of Science:

  • Pediatric Sleep Medicine
  • Craniofacial Abnormalities
  • Neurodevelopmental Disorders

Background:

  • Robin sequence (RS) is a congenital condition affecting facial development, often associated with airway obstruction.
  • Obstructive sleep apnea (OSA) is a common complication in children with RS, potentially impacting long-term health.
  • Early intervention with devices like the Tuebingen palatal plate aims to manage RS-related airway issues.

Purpose of the Study:

  • To evaluate neurocognitive and behavioral outcomes in primary school-aged children with RS.
  • To investigate the prevalence and impact of obstructive sleep apnea (OSA) in this cohort.
  • To assess the effectiveness of early palatal plate treatment on long-term outcomes.

Main Methods:

  • A cohort of 42 primary school-aged children (21 with RS, 21 controls) underwent polysomnography.
  • Intelligence was assessed using the Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V).
  • Sleep habits and behavior were evaluated through sleep diaries, CSHQ, and CBCL questionnaires.

Main Results:

  • Children with RS exhibited a significantly higher obstructive apnea-hypopnea index (OAHI) compared to controls.
  • Despite normal overall intelligence quotient (IQ) scores, children with RS showed increased risk for externalizing behavioral problems.
  • One child with RS was diagnosed with severe OSA (OAHI 57/h) despite a previously unremarkable history.

Conclusions:

  • Children with Robin sequence face an elevated risk for OSA and associated behavioral challenges.
  • Regular OSA screening is recommended throughout childhood for individuals with RS.
  • Adequate treatment of OSA during infancy supports normal neurocognitive development in children with RS.
Abstract

Keywords:
Robin sequenceneurocognitive and behavioral outcomeobstructive sleep apneasleep-disordered breathingupper airway obstruction

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