Screening for Obstructive Sleep Apnea in Preschool Children With Cleft Palate

Objective: The objective of this study was to explore the prevalence, range of reported symptoms, and clinical risk factors of obstructive sleep apnea in preschool children with cleft lip and/or palate. Design: Questionnaires were distributed to parents/guardians of all children from birth to 5 years of age who were followed by the cleft clinic. Results: Questionnaire data and cleft classification were available for 248 children, with a mean age of 33.4 months. Obstructive sleep apnea was Identified In 31.4% of the children. Only 29.5% of children with obstructive sleep apnea had undergone an Investigation of these symptoms. The three most common symptoms reported in children with a questionnaire diagnosis of obstructive sleep apnea were (1) "heavy or loud breathing," (2) "easily distracted," and (3) "on the go" or "driven by a motor." The only clinical risk factor associated with a questionnaire diagnosis of obstructive sleep apnea was the presence of a syndrome (chi(2) = 3.5, p = .05). There were no significant differences In risk of obstructive sleep apnea by age, cleft classification, and surgical status. Conclusion: Preschool children with cleft lip and/or palate have a risk of obstructive sleep apnea that Is as much as five times that of children without cleft. Obstructive sleep apnea appears to be underrecognized in this group of children. Further research Is needed to investigate Important risk factors for obstructive sleep apnea in children with cleft lip and/or palate.