Increased Prevalence of Obstructive Sleep Apnea in Patients With Cleft Palate

Objective: To evaluate the prevalence of sleep-disordered breathing (SDB) and/or obstructive sleep apnea (OSA) in the population with nonsyndromic cleft palate. Design: Retrospective medical record review of symptoms of SDB and/or OSA and results of polysomnography (PSG) studies. Setting: The craniofacial clinic of a tertiary pediatric hospital. Patients: A total of 459 patients, with an additional 48 patients with Pierre Robin syndrome, met inclusion criteria. Main Outcome Measures: Medical records from January 1, 2005, through July 31, 2009, were reviewed for demographic data, SDB symptoms, surgical procedures, and PSG results. Results: Of the 459 patients, 172 (37.5%) had symptoms of SDB and 39 (8.5%) had PSG-diagnosed OSA. Forty-six patients underwent 1 or more PSGs, with results of 49 of the 59 studies (83.1%) being positive for OSA. Surgical procedures to address SDB and/or OSA were undertaken in 89 patients (51.7%), with combined tonsillectomy and adenoidectomy the most common procedure (44.9%). An additional 48 patients who met the inclusion criteria with a diagnosis of Pierre Robin syndrome were also identified. In this population, 35 patients (72.9%) had symptoms of SDB and/or OSA. Conclusions: An increased prevalence of SDB and/or OSA exists in the population with cleft palate, with an even greater prevalence in patients with Pierre Robin syndrome. Definitive diagnosis of OSA by PSG is under-used. We suggest that surgical management of SDB and/or OSA be followed by PSG to demonstrate resolution or persistence of symptoms to ensure appropriate further management.