{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T01:44:20Z","timestamp":1783734260878,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T00:00:00Z","timestamp":1629244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Children with cleft are at high risk for sleep\u2010disordered breathing (SDB). However, little is known about the impact of SDB in this pediatric population. The aim of this study was to investigate whether SDB play a role in behavior and quality of life (QoL) in young children with cleft.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional study of 95 children aged 2.0\u20137.9 years with cleft palate. Parents completed a sleep (Pediatric Sleep questionnaire), a behavior (Conners' Early Childhood scale), and a generic health\u2010related QoL (KINDL questionnaire) assessment. Symptomatic children were referred for a polysomnography (PSG).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 14.7% of children (49.5% boys) screened positive for SDB and 27.4% had a PSG, which identified 84.6% with sleep apnea (apnea\u2010hypopnea index [AHI]\u2009\u22651) and 27.2% with AHI\u2009\u22655. Positive screening for SDB was associated with elevated T\u2010scores for anxiety and physical symptoms, significant differences in mean T\u2010scores for inattention\/hyperactivity (64.2\u2009\u00b1\u200915.7 vs. 53.9\u2009\u00b1\u200911.4, <jats:italic>p<\/jats:italic>\u2009=\u2009.02), social functioning\/atypical behaviour, social functioning (60.6\u2009\u00b1\u200911.7 vs. 51.9\u2009\u00b1\u20097.3, <jats:italic>p<\/jats:italic>\u2009=\u2009.004 and 59.5\u2009\u00b1\u200910.9 vs. 51.2\u2009\u00b1\u20098.0, <jats:italic>p<\/jats:italic>\u2009=\u2009.01) and mood (57.5\u2009\u00b1\u20098.2 vs. 50.7\u2009\u00b1\u20098.2, <jats:italic>p<\/jats:italic>\u2009=\u2009.03). Lower QoL scores for emotional and family well\u2010being were also reported in children with SDB (80.7\u2009\u00b1\u200913.4 vs. 90.0\u2009\u00b1\u20098.7, <jats:italic>p<\/jats:italic>\u2009=\u2009.01, 66.7\u2009\u00b1\u200915.8 vs. 76.9\u2009\u00b1\u200911.9, <jats:italic>p<\/jats:italic>\u2009=\u2009.04). Children with AHI\u2009\u22655 compared to those with AHI\u2009\u22651 and &lt;5 showed significant differences in mean T\u2010score for aggressive behaviour (65.2\u2009\u00b1\u200912.1 vs. 52.3\u2009\u00b1\u200911.3, <jats:italic>p<\/jats:italic>\u2009=\u2009.04), defiant temper (62.8\u2009\u00b1\u20099.2 vs. 51.6\u2009\u00b1\u200910.2, <jats:italic>p<\/jats:italic>\u2009=\u2009.03) and lower family QoL scores (59.4\u2009\u00b1\u200915.2 vs. 77.1\u2009\u00b1\u20099.6, <jats:italic>p<\/jats:italic>\u2009=\u2009.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In children with cleft palate the presence of SDB symptoms and moderate\/severe sleep apnea was associated with behavioral (internalizing\/externalizing) problems and lower family well\u2010being.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.25611","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T19:12:23Z","timestamp":1629313943000},"page":"3358-3365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of sleep\u2010disordered breathing on behavior and quality of life in children aged 2 to 7 years with non\u2010syndromic cleft lip and\/or palate"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4312-7189","authenticated-orcid":false,"given":"Marta","family":"Moraleda\u2010Cibri\u00e1n","sequence":"first","affiliation":[{"name":"Michael S. Aldrich Sleep Disorders Laboratory and Sleep Disorders Clinic, Department of Neurology University of Michigan Ann Arbor Michigan USA"},{"name":"Sleep Disorders Center, Centro M\u00e9dico Teknon Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean P.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Kasten","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth A.","family":"Warschausky","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"Buchman","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carme","family":"Monasterio\u2010Ponsa","sequence":"additional","affiliation":[{"name":"Unit of Sleep Disorders, Department of Neumology Hospital Universitari de Bellvitge Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7512-9701","authenticated-orcid":false,"given":"Louise M.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Michael S. Aldrich Sleep Disorders Laboratory and Sleep Disorders Clinic, Department of Neurology University of Michigan Ann Arbor Michigan USA"},{"name":"Department of Oral and Maxillofacial Surgery University of Michigan Ann Arbor Michigan USA"},{"name":"Department of Obstetrics and Gynecology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200708-135MG"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/33.11.1447"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2009.04.008"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-0620"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsy180"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.3536"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2012-302104"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2011.8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318158195e"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.5554"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.4360"},{"issue":"1","key":"e_1_2_8_13_1","first-page":"21","article-title":"Reading disability in children with clefts","volume":"25","author":"Richman LC","year":"1988","journal-title":"Cleft Palate J"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1597\/08-213"},{"key":"e_1_2_8_15_1","first-page":"B352","article-title":"[Psychosocial adjustment in children with a cleft lip and\/or palate]","volume":"153","author":"Hoek IHC","year":"2009","journal-title":"Ned Tijdschr Geneeskd"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/22.4.487"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3660"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2018.07.004"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2019.109598"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.5125\/jkaoms.2017.43.4.247"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(99)00009-X"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20236"},{"key":"e_1_2_8_23_1","unstructured":"ConnersE.Conners Early Childhood Parents Rating Scale. North Tonawanda NY: Multi\u2010Health System Inc; 2009."},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchp.2016.07.003"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1087054720907955"},{"issue":"1","key":"e_1_2_8_26_1","first-page":"42","article-title":"Validity and reliability of the Persian version of conner\u2019s adult ADHD rating scales: observer and self\u2010report screening versions","volume":"3","author":"Sadeghi\u2010Bazargani H.","year":"2014","journal-title":"J Clin Res"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2015.04.020"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21093"},{"issue":"4","key":"e_1_2_8_29_1","first-page":"249","article-title":"Psychological characteristics of children with cleft lip and palate: intellectual, achievement, behavioral and personality variables","volume":"19","author":"Richman LC","year":"1982","journal-title":"Cleft Palate J."},{"key":"e_1_2_8_30_1","first-page":"4","article-title":"Behavior and achievement of cleft palate children","volume":"13","author":"Richman LC","year":"1976","journal-title":"Cleft Palate Journal."},{"issue":"3","key":"e_1_2_8_31_1","first-page":"209","article-title":"Type of facial cleft, associated congenital malformations, and parents' ratings of school and conduct problems","volume":"24","author":"Tobiasen JM","year":"1987","journal-title":"Cleft Palate J."},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11689-010-9060-5"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/1055665619853749"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.25611","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.25611","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.25611","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T19:35:12Z","timestamp":1693337712000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.25611"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,18]]},"references-count":32,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1002\/ppul.25611"],"URL":"https:\/\/doi.org\/10.1002\/ppul.25611","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,18]]},"assertion":[{"value":"2021-02-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}