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Micrognathia and cleft palate as a cause of obstructive sleep apnoea in infants

Turkka Kirjavainen1,2,3, Pia Vuola4, Janne Suominen5

  • 1Department of Paediatrics, New Children's Hospital, Helsinki, Finland.

Acta Paediatrica (Oslo, Norway : 1992)
|December 5, 2024
PubMed

Insights

Obstructive sleep apnoea (OSA) in infants with Robin sequence (RS) is primarily linked to micrognathia, not cleft palate. Sleep positioning significantly impacts OSA severity in RS infants.

Area of Science:

  • Pediatric Sleep Medicine
  • Craniofacial Anomalies
  • Respiratory Physiology

Background:

  • Obstructive sleep apnoea (OSA) is a common complication in infants diagnosed with Robin sequence (RS).
  • The interplay between micrognathia, cleft palate, and sleep positioning in influencing OSA severity in this population requires further investigation.

Purpose of the Study:

  • To investigate the independent and combined effects of micrognathia and cleft palate on the severity of obstructive sleep apnoea (OSA) in infants.
  • To determine the influence of sleep positioning (supine, side, prone) on OSA in infants with Robin sequence.

Main Methods:

  • Analysis of a 13-year national reference centre polysomnography (PSG) dataset.
  • Included infants with Robin sequence and cleft palate, Robin sequence without cleft palate, and cleft palate without micrognathia.
  • Polysomnography (PSG) was conducted during daytime sleep recordings at a median age of 5 weeks.

Main Results:

  • Infants with Robin sequence exhibited significantly more severe OSA compared to those with cleft palate alone (e.g., higher obstructive apnoea-hypopnoea index, lower SpO2).
  • In infants with Robin sequence, OSA severity was demonstrably sleep-position dependent, with reduced severity observed in side and prone sleeping positions compared to supine.
  • Micrognathia was identified as a more critical factor than cleft palate in determining the degree of OSA severity.

Conclusions:

  • Micrognathia is the predominant factor contributing to obstructive sleep apnoea severity in infants with Robin sequence.
  • Sleep positioning plays a crucial role in modulating OSA in infants with RS, with non-supine positions potentially mitigating severity.
Abstract

Keywords:
Cleft palateInfantsPolysomnographyRobin sequenceSleep apnea

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