Cleft lip and/or palate and breathing during sleep

MacLean, Joanna E.; Hayward, Peter; Fitzgerald, Dominic A.; Waters, Karen

doi:10.1016/j.smrv.2009.03.001

« Previous Next »Sleep Medicine Reviews
Volume 13, Issue 5 , Pages 345-354, October 2009

Cleft lip and/or palate and breathing during sleep

Joanna E. MacLean
- Discipline of Paediatrics & Child Health, Faculty of Medicine, University of Sydney, NSW, Australia
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Corresponding author at: Department of Respiratory Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, Australia. Tel.: +61 2 9845 0000; fax: +61 2 9845 3633.
Peter Hayward
- Department of Plastic Surgery, The Children's Hospital at Westmead, Sydney, NSW, Australia
Dominic A. Fitzgerald
- Discipline of Paediatrics & Child Health, Faculty of Medicine, University of Sydney, NSW, Australia
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia
Karen Waters
- Discipline of Paediatrics & Child Health, Faculty of Medicine, University of Sydney, NSW, Australia
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia

Summary

Cleft of the lip and/or palate (CL/P) is a common defect which is associated with changes in facial structures and a smaller upper airway. As a result, infants and children with CL/P have an increased risk of sleep disordered breathing (SDB). This paper will review the anatomical and functional factors which place infants and children with CL/P at increased risk of SDB as well as review the literature which defines the magnitude of this risk. The information available on treatment of SDB in infants and children with CL/P will be presented. Finally, outstanding issues relevant to SDB in children with CL/P are discussed with direction for future research.

Keywords: Sleep apnoea, Palatoplasty, Pharyngoplasty, Pharyngeal flap, Velo-pharyngeal insufficiency, Prone positioning, Adenotonsillectomy, Continuous positive airway pressure, Mandibular distraction