Sleep and Neurobehavioral Performance After Cleft Palate Repair

腭裂修复后的睡眠和神经行为表现

• 批准号: 7530706
• 负责人: LOUISE M O'BRIEN
• 金额: $ 19.31万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7530706
• 关键词: 10 year old; Accounting; Affect; Age; Air; Apnea; Attention; Behavior; Behavioral; Case Study; Child; Childhood; Classification; Cleaved cell; Cleft Lip; Cleft Palate; Clinical; Cognitive; Congenital Abnormality; Controlled Study; Data; Development; Diagnosis; Dose; Evaluation; Excision; Goals; Hyperactive behavior; Infant; Learning; Legal patent; Measurement; Measures; Medical; Michigan; Morbidity - disease rate; Mucocele; Neuropsychological Tests; Newborn Infant; Nose; Obstruction; Obstructive Sleep Apnea; Operative Surgical Procedures; Oral cavity; Outcome; Parents; Performance; Polysomnography; Problem behavior; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Resistance; Risk; Robin bird; Schools; Severities; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Soft Palate; Speech; Symptoms; Testing; Time; Uncontrolled Study; United States; Universities; behavior rating scale; craniofacial; esophagus pressure; high risk; impression; improved; inattention; innovation; instrument; malformation; multidisciplinary; neurobehavioral; neuropsychological; orofacial; palate repair; programs; prospective; public health relevance; repaired; response

DESCRIPTION (provided by applicant): Cleft palate is a highly prevalent craniofacial malformation that affects approximately one in 700 newborns in the U.S. Studies on small numbers of children have raised the concern that repair of the cleft palate increases later risk for obstructive sleep apnea (OSA). However, the extent to which children who have had cleft palate repair have an increased risk for OSA has not been well defined. The issue is important because OSA is associated with significant morbidity, including behavioral problems, learning difficulties, and poor school performance, all of which may improve when the sleep disorder is treated. Furthermore, anecdotal reports and clinical impressions suggest that children with cleft palate repairs, in the absence of other medical conditions, are at high risk for neuropsychological problems. The possibility that OSA could be the underlying cause has never been studied. The main goal of the proposed research, therefore, is to examine the relationships between cleft palate repair, OSA, and neuropsychological problems in children. The investigators will recruit 40 children with previous cleft palate repair who are attending the multidisciplinary Craniofacial Anomalies Program at the University of Michigan. In addition, 40 children of similar ages with previous repair of cleft lip only, excision of a mucocele, or a frenulectomy will be recruited to serve as controls. All children will undergo nocturnal polysomnography followed by neuropsychological testing. Specific Aim 1 will determine whether OSA is more prominent among children with past repair of cleft palate rather than controls. Aim 2 will assess whether children with cleft palate repairs have more prominent neuropsychological problems, especially in attention and activity levels, two domains most sensitive to effects of OSA. Aim 3 will test whether measures of OSA may explain some neuropsychological measures in children with cleft palate repair, to demonstrate for the first time that undiagnosed OSA could underlie adverse neuropsychological morbidity. Results will highlight the importance of attention to the upper airway years after repair of cleft palate, suggest a mechanism to explain ongoing neuropsychological morbidity in these children, and provide data necessary to justify larger and more definitive studies of the potential unintended impact of cleft palate repair. PUBLIC HEALTH RELEVANCE: Cleft palate is a common birth defect affecting about 1 in 700 children in the US. We believe that the behavioral problems reported in these children may be due to undiagnosed sleep apnea, a condition common in children with other medical problems. Results from this study could help to focus the attention of clinicians on a common sleep disorder that may be ignored in these children but which may improve their behavioral problems if diagnosed and treated.

描述（由申请人提供）：left裂是一种高度普遍的颅面畸形，影响了美国少数儿童研究中约有700名新生儿的大约有一个，这引起了人们的担忧，即修复left裂的后期会增加阻塞性睡眠呼吸暂停（OSA）的后续风险。但是，口口修复的儿童在多大程度上尚未确定OSA的风险增加。这个问题很重要，因为OSA与重大发病率有关，包括行为问题，学习困难和学校表现不佳，所有这些都可能在治疗睡眠障碍时会有所改善。此外，轶事的报告和临床印象表明，在没有其他医疗状况的情况下，进行left裂的儿童有神经心理问题的高风险。 OSA可能是根本原因的可能性从未被研究过。因此，拟议研究的主要目标是检查儿童裂口修复，OSA和神经心理问题之间的关系。调查人员将招募40名患有cle裂修复的儿童，他们正在密歇根大学参加多学科颅面异常计划。此外，将仅招募40名相似年龄的儿童，并以前仅修复唇裂，粘液切除或结膜切除术以作为对照。所有儿童都会进行夜间多肌表演术，然后进行神经心理学测试。特定的目标1将确定OSA在过去修复裂口而不是对照的儿童中是否更突出。 AIM 2将评估裂口修复的儿童是否存在更突出的神经心理学问题，尤其是在注意力和活动水平上，这是对OSA影响最敏感的两个领域。 AIM 3将测试OSA的措施是否可以解释left裂修复儿童的某些神经心理学措施，以证明未经诊断的OSA可能是不良神经心理学发病率的基础。结果将强调对裂口修复后几年的关注几年的关注的重要性，提出了一种解释这些儿童中持续的神经心理发病率的机制，并提供了必要的数据，以证明对left裂修复的潜在意外影响的更大和更明确的研究。公共卫生相关性：left裂是一种常见的出生缺陷，影响了美国700名儿童中约1个。我们认为，这些儿童报告的行为问题可能是由于无法诊断的睡眠呼吸暂停引起的，这是在患有其他医疗问题的儿童中常见的情况。这项研究的结果可能有助于将临床医生的注意力集中在这些儿童中可能会忽略的常见睡眠障碍上，但如果被诊断和治疗可能会改善其行为问题。