Sleep outcomes in children with hemifacial microsomia and controls: a follow-up study.
OBJECTIVE
Children with craniofacial anomalies are at high risk for sleep-disordered breathing (SDB), yet its prevalence among children with craniofacial conditions is not known. Children with hemifacial microsomia (HFM) are likely particularly vulnerable to SDB as a result of underdevelopment of the mandible and oropharynx. Nevertheless, most children with HFM are not referred for sleep studies. We hypothesized that sleep outcomes would be worse in children with HFM versus control subjects.


METHODS
We conducted a follow-up study among 124 case participants and 349 control subjects who previously participated in a study of HFM risk factors. Parents completed the Pediatric Sleep Questionnaire (PSQ) regarding symptoms of SDB and sleep habits. Regression models were adjusted for region, age, sex, race/ethnicity, and maternal education.


RESULTS
Snoring was more commonly reported for children with HFM (29%) than for control subjects (17%). Compared with control subjects, children with HFM more often had symptoms consistent with SDB. On average, case participants' parents reported 1.9 times as many symptoms on the PSQ breathing scale and 1.3 times more symptoms on the PSQ sleepiness scale than did control subjects' parents, with little difference on the PSQ behavior scale. Parents of children with HFM reported 1.4 times more night awakenings than did control subjects' parents.


CONCLUSIONS
Children with HFM experienced more snoring and other symptoms of SDB than did control subjects. Pediatricians should be aware of the increased vulnerability for SDB among children with mandibular or external ear underdevelopment or asymmetry and should refer to a sleep specialist as needed.
Cloonan
Yona K
YK
Department of Epidemiology, Michigan State University, East Lansing, Michigan 48823, USA. yona@msu.edu
Kifle
Yemiserach
Y
Davis
Scott
S
Speltz
Matthew L
ML
Werler
Martha M
MM
Starr
Jacqueline R
JR
D002170:Canada; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005146:Facial Asymmetry / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000209:etiology*; D012913:Snoring / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires; D014481:United States