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Management of Obstructive Sleep Apnea in Children With Cleft Palate and/or Velopharyngeal Insufficiency: A Primer on

Matthew Maksimoski1,2, Thomas J Sitzman3,4, Raymond W Tse5,6

  • 1Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, WI, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|November 10, 2025
PubMed

Insights

Obstructive sleep apnea (OSA) is common in children with cleft and craniofacial conditions. This review offers guidance on OSA evaluation and management for healthcare teams caring for these unique patients.

Area of Science:

  • Pediatric medicine
  • Sleep medicine
  • Craniofacial medicine

Background:

  • Obstructive sleep disordered breathing (oSDB), including obstructive sleep apnea (OSA), frequently coexists with cleft lip and palate, velopharyngeal insufficiency (VPI), and other craniofacial conditions.
  • oSDB significantly impacts quality of life, health, surgical planning, and development in children, particularly those with craniofacial anomalies.
  • oSDB is a critical consideration in surgical decisions for cleft palate and velopharyngeal procedures.

Purpose of the Study:

  • To provide a primer on obstructive sleep apnea (OSA) evaluation and management for healthcare professionals on cleft and craniofacial teams.
  • To discuss screening, diagnostic methods, and interpretation of OSA testing in pediatric populations.
  • To highlight considerations for specific craniofacial conditions and the impact of VPI surgery on OSA.

Main Methods:

  • Review of current literature on oSDB screening, diagnosis, and management in children.
  • Discussion of OSA testing interpretation and its application in craniofacial populations.
  • Examination of management strategies for OSA in children with cleft and craniofacial conditions.

Main Results:

  • Children with craniofacial conditions, including cleft palate and VPI, have altered risk profiles for OSA.
  • Increased awareness and diagnostic access have identified specific patient populations benefiting from OSA screening.
  • VPI surgery can impact OSA, necessitating careful management considerations.

Conclusions:

  • Healthcare teams managing children with cleft and craniofacial conditions require knowledge of OSA screening, diagnostics, and management.
  • Tailored OSA management approaches are crucial for children with these complex conditions.
  • Early identification and appropriate management of OSA improve outcomes for pediatric patients with craniofacial anomalies.

Keywords:
cleft palateobstructive sleep apneapediatricsleep-disordered breathingvelopharyngeal insufficiency

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