Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 May 1;37(5):919-25.
doi: 10.5665/sleep.3660.

Impact of sleep and breathing in infancy on outcomes at three years of age for children with cleft lip and/or palate

Courtney B Smith  1 , Karen Walker  2 , Nadia Badawi  2 , Karen A Waters  3 , Joanna E MacLean  4
Affiliations

Impact of sleep and breathing in infancy on outcomes at three years of age for children with cleft lip and/or palate

Courtney B Smith et al. Sleep. .

Abstract

Study objectives: To evaluate the relationship between sleep disordered breathing (SDB) in early infancy and outcomes at 3 years of age in children with cleft lip and/or palate (CL/P).

Design: Observational follow-up study.

Setting: Multidisciplinary CL/P clinic, tertiary centre.

Participants: Children with CL/P who participated in a study of sleep and breathing in infancy.

Measurements and results: The families of 52 children were approached for this follow-up study. The children underwent neurocognitive (Bayley Scales of Infant and Toddler Development, Third Edition; BSID-III), quality of life (Infant/Toddler Quality of Life Questionnaire; ITQOL), and growth assessments at 3 years. The families of 33 children (66%) completed follow-up at 36.7 ± 1.4 months. The apnea-hypopnea index (AHI) in infancy was 23.9 ± 18.0 events/h. Mean group BSID-III scores fell within the standardized normal range (10 ± 3) for all domains; however, language scores were lower than control children. Quality of life scores and growth parameter z-scores were similar to published control data. PSG variables in infancy showed significant relationships with outcomes at 3 years of age; lower percentage of AS/REM sleep was associated with lower cognition score; more obstructive events were associated with lower global behavior ITQOL score; and higher number of respiratory events in infancy was associated with lower weight z-score.

Conclusion: Neurocognition, quality of life, and growth measures from children with CL/P fall within a normal range; however, scores in the language domain are lower than controls. Sleep and respiratory elements of SDB in infancy appear to modify these outcomes at 3 years of age.

Keywords: Bayley Scales of Infant and Toddler Development; Infant/Toddler Quality of Life Questionnaire; cleft lip and/or palate; longitudinal.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Bayley scaled scores distribution by Domain. Bayley scaled scores have a range of 1-19, with a mean of 10 (SD 3). Error bars represent the 95% confidence interval around the mean group score.
See this image and copyright information in PMC

References

    1. MacLean JE, Hayward P, Fitzgerald DA, Waters K. Cleft lip and/or palate and breathing during sleep. Sleep Med Rev. 2009;13:345–54. - PubMed
    1. Hermann NV, Kreiborg S, Darvann TA, Jensen BL, Dahl E, Bolund S. Early craniofacial morphology and growth in children with unoperated isolated cleft palate. Cleft Palate Craniofac J. 2002;39:604–22. - PubMed
    1. Mortimore IL, Douglas NJ. Palatal muscle EMG response to negative pressure in awake sleep apneic and control subjects. Am J Respir Crit Care Med. 1997;156:867–73. - PubMed
    1. Malhotra A, Trinder J, Fogel R, et al. Postural effects on pharyngeal protective reflex mechanisms. Sleep. 2004;27:1105–12. - PMC - PubMed
    1. MacLean JE, Fitzsimons D, Hayward P, Waters KA, Fitzgerald DA. The identification of children with cleft palate and sleep disordered breathing using a referral system. Pediatr Pulmonol. 2008;43:245–50. - PubMed

Publication types