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BACKGROUND:The incidence of obstructive sleep apnea (OSA) in the cleft palate (CP) population, an at-risk group, is unknown. Those with cleft palate and tongue-based airway obstruction (TBAO) due to the large size of the tongue relative to a small jaw have been shown to have an increased risk of obstructive sleep apnea (OSA), but there is little data quantifying the risk of OSA in the overall CP population. The purpose of this study is to elucidate the incidence of OSA in CP patients by screening with the Chervin Pediatric Sleep Questionnaire (PSQ).
METHODS:All patients presenting to the CP team at CHOP from January 2011-March 2012 were given the Chervin PSQ. This validated screening tool, with a specificity of 72% and sensitivity of 78%, asked 22 questions about sleep habits, snoring, wakefulness during the day, and sleep fragmentation. Any score greater than 8 was considered a positive screen per the guidelines of the PSQ. Data were tabulated and subdivided by age and gender.
RESULTS:There were 146 responses in children ranging from 2 to 18 years old with a mean age of 8.7 years. The overall incidence of a positive screen was 14.9%. Percentage of children screening positive from 2-5 years old was 10%; 6-9 years old was 22%; 10 - 14 years old was 26%; and 15-18 years old was 12%. Overall, the average number of positive answers to the 22 questions was 4.
CONCLUSIONS:The incidence of OSA in CP by the Chervin PSQ is 14.9%, supporting the hypothesis that the CP cohort is “at risk” for OSA. It is important to recognize that the Chervin PSQ is only a screening tool, and further work is ongoing to correlate these findings with polysomnography.