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Sleep-Disordered Breathing in Children With Craniofacial Syndromes

Ganeshraj Sivaram1, Kahir Jawad2, Karim El-Kersh3

  • 1Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, University of Louisville School Medicine, Louisville, KY, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|September 17, 2025
PubMed

Insights

Obstructive sleep apnea (OSA) is highly prevalent in children with craniofacial syndromes (CFS), affecting nearly 70%. Mandibular distraction osteogenesis (MDO) significantly improves sleep quality in these patients, particularly those with Pierre Robin Sequence (PRS).

Area of Science:

  • Pediatric Pulmonology
  • Craniofacial Surgery
  • Sleep Medicine

Background:

  • Obstructive sleep apnea (OSA) is a significant concern in children with craniofacial syndromes (CFS).
  • Limited data exists on the prevalence and management of OSA in this specific pediatric population.
  • Craniofacial abnormalities can predispose children to airway obstruction during sleep.

Purpose of the Study:

  • To determine the prevalence of OSA in children with CFS.
  • To characterize the polysomnographic (PSG) findings in this cohort.
  • To describe the management strategies and outcomes of OSA in children with CFS.

Main Methods:

  • Retrospective chart review of patients under 18 with CFS and PSG data at a single tertiary care center.
  • Analysis of medical and surgical history, and PSG parameters including apnea-hypopnea index (AHI) and oxygen saturation (SpO2).
  • Evaluation of treatment outcomes, focusing on mandibular distraction osteogenesis (MDO) in patients with Pierre Robin Sequence (PRS).

Main Results:

  • 46 children with CFS were included; 69.6% had OSA, with 39.1% severe.
  • OSA prevalence was 93.8% in the 16 patients with Pierre Robin Sequence (PRS).
  • MDO significantly reduced AHI, REM AHI, and EtCO2, while increasing SpO2 and total sleep time in PRS patients.

Conclusions:

  • OSA is more common in children with CFS than previously thought.
  • Mandibular distraction osteogenesis (MDO) is the primary treatment for OSA in this cohort and yields significant improvements.
  • Pierre Robin Sequence (PRS) is the most frequent craniofacial syndrome associated with OSA in children, benefiting greatly from MDO.

Keywords:
Pierre-Robin sequencecraniofacial surgerysleep disorders

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