Moraleda-Cibrián Marta, Edwards Sean P, Kasten Steven J, Berger Mary, Buchman Steven R, O'Brien Louise M
Sleep Disorders Center, Department of Neurology ; Department of Oral & Maxillofacial Surgery.
Department of Oral & Maxillofacial Surgery.
J Clin Sleep Med. 2014 Mar 15;10(3):307-12. doi: 10.5664/jcsm.3536.
The purpose of this study was to investigate the frequency of sleep disordered breathing (SDB) symptoms in a clinical sample of children with congenital craniofacial malformations (CFM) followed at a tertiary medical center and non-selected for sleep problems.
Cross-sectional study of 575 children aged 2-18 years followed at the Craniofacial Anomalies Program between March 2007 and May 2011. The Sleep-Related Breathing Disturbance scale of the Pediatric Sleep Questionnaire was used to screen for SDB, snoring, and sleepiness. A cutoff value ≥ 0.33 of the total answered questions identified children with positive screening for SDB symptoms.
Overall, 25% of children screened positive for SDB, 28% for snoring, and 20% for sleepiness. In children with non-syndromic CFM, those with Robin sequence had the highest frequency of SDB, snoring, and sleepiness (43%, 44%, and 38%, respectively). In children with syndromic CFM, velocardiofacial/ DiGeorge syndrome had the highest frequency of SDB and sleepiness (48% and 43%, respectively). Children with Treacher Collins had the highest frequency of snoring (83%). The presence of cleft palate was not associated with an increased frequency of SDB symptoms. Nevertheless, children with syndromic CFM, compared to those with non-syndromic CFM, had a higher SDB score (0.27 ± 0.21 vs.0.21 ± 0.19, p = 0.003) and were more likely to have sleepiness (26% vs. 18%, p = 0.05).
Congenital craniofacial malformations in children are associated with high risk for SDB symptoms. Our findings should encourage a high index of suspicion for SDB in children with CFM, with a low threshold for further testing and close follow-up.
Moraleda-Cibrián M; Edwards SP; Kasten SJ; Berger M; Buchman SR; O'Brien LM. Symptoms of sleep disordered breathing in children with craniofacial malformations.
本研究旨在调查在一家三级医疗中心随访的先天性颅面畸形（CFM）儿童临床样本中睡眠呼吸障碍（SDB）症状的发生率，这些儿童未因睡眠问题而被挑选。
对2007年3月至2011年5月期间在颅面畸形项目中随访的575名2至18岁儿童进行横断面研究。使用儿童睡眠问卷中与睡眠相关的呼吸障碍量表来筛查SDB、打鼾和嗜睡情况。对所回答问题的总分≥0.33作为识别SDB症状筛查呈阳性儿童的临界值。
总体而言，25%的儿童SDB筛查呈阳性，28%打鼾，20%嗜睡。在非综合征性CFM儿童中，患有罗宾序列征的儿童SDB、打鼾和嗜睡的发生率最高（分别为43%、44%和38%）。在综合征性CFM儿童中，腭心面/迪乔治综合征的SDB和嗜睡发生率最高（分别为48%和43%）。患有特雷彻·柯林斯综合征的儿童打鼾发生率最高（83%）。腭裂的存在与SDB症状发生率增加无关。然而，与非综合征性CFM儿童相比，综合征性CFM儿童的SDB评分更高（0.27±0.21对0.21±0.19，p = 0.003），且更易出现嗜睡（26%对18%，p = 0.05）。
儿童先天性颅面畸形与SDB症状的高风险相关。我们的研究结果应促使对CFM儿童的SDB保持高度怀疑指数，进一步检查的阈值要低并密切随访。
莫拉莱达 - 西布里安M；爱德华兹SP；卡斯滕SJ；伯杰M；布赫曼SR；奥布赖恩LM。颅面畸形儿童的睡眠呼吸障碍症状。
