{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:59:59Z","timestamp":1784674799074,"version":"3.55.0"},"reference-count":24,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union","award":["101156275\u2014ERN CRANIO 2023-2027"],"award-info":[{"award-number":["101156275\u2014ERN CRANIO 2023-2027"]}]},{"name":"European Union","award":["DGECR-2022-00433"],"award-info":[{"award-number":["DGECR-2022-00433"]}]},{"name":"European Union","award":["RGPIN-2022-03068"],"award-info":[{"award-number":["RGPIN-2022-03068"]}]},{"name":"Advancement of Women in Science (T\u00fcFF)","award":["101156275\u2014ERN CRANIO 2023-2027"],"award-info":[{"award-number":["101156275\u2014ERN CRANIO 2023-2027"]}]},{"name":"Advancement of Women in Science (T\u00fcFF)","award":["DGECR-2022-00433"],"award-info":[{"award-number":["DGECR-2022-00433"]}]},{"name":"Advancement of Women in Science (T\u00fcFF)","award":["RGPIN-2022-03068"],"award-info":[{"award-number":["RGPIN-2022-03068"]}]},{"name":"Natural Sciences and Engineering Research Council of Canada (NSERC)","award":["101156275\u2014ERN CRANIO 2023-2027"],"award-info":[{"award-number":["101156275\u2014ERN CRANIO 2023-2027"]}]},{"name":"Natural Sciences and Engineering Research Council of Canada (NSERC)","award":["DGECR-2022-00433"],"award-info":[{"award-number":["DGECR-2022-00433"]}]},{"name":"Natural Sciences and Engineering Research Council of Canada (NSERC)","award":["RGPIN-2022-03068"],"award-info":[{"award-number":["RGPIN-2022-03068"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: The prone position is one of the most frequently used treatment options for infants with Robin sequence (RS), but its effect and its safety regarding the increased risk of sudden infant death syndrome are controversial. Methods: In a prospective randomized crossover study, we investigated the effects of the prone versus supine position on obstructive sleep apnea (OSA) using polygraphy. Infants with RS admitted to the University Hospital Tuebingen between 4\/2021 and 5\/2023 were analyzed for their obstructive apnea index (OAI), oxygen desaturation index &lt; 80%, minimum and basal oxygen saturation, basal and highest transcutaneous carbon dioxide level, and respiratory and heart rate in both sleep positions. Results: A total of 29 children were analyzed. A total of 21\/29 children were measured in both positions, while 6\/29 children were only measured in the supine position and 2\/29 only in the prone position. We found no significant difference in the OAI for the supine versus prone position in main effects analyses. In unadjusted linear model analysis, infants in the supine position had an OAI of 9.9 (95% CI, \u22122.4, 22.3) events\/h higher than those in the prone position. A total of 13\/21 infants benefitted from the prone position, whilst 8\/21 had a worsening of their OSA. We found no evidence of a significant interaction between sleeping position and syndromic status. Conclusions: Prone positioning improves, but does not eliminate, OSA symptoms in infants with RS, and severe OSA may often persist. There are infants in whom a change to the prone position leads to a worsening of their OSA.<\/jats:p>","DOI":"10.3390\/children12030389","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T07:59:54Z","timestamp":1742457594000},"page":"389","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Randomized Crossover Trial to Evaluate the Effect of Positioning on Obstructive Sleep Apnea in Infants with Robin Sequence"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6850-6249","authenticated-orcid":false,"given":"Cornelia","family":"Wiechers","sequence":"first","affiliation":[{"name":"Department of Neonatology, Tuebingen University Hospital, Calwerstrasse 7, 72076 Tuebingen, Germany"},{"name":"Center for Cleft Lip, Palate and Craniofacial Malformations, Tuebingen University Hospital, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Goetz","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Tuebingen University Hospital, Calwerstrasse 7, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7561-3050","authenticated-orcid":false,"given":"Karen","family":"Kreutzer","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Tuebingen University Hospital, Calwerstrasse 7, 72076 Tuebingen, Germany"},{"name":"Center for Cleft Lip, Palate and Craniofacial Malformations, Tuebingen University Hospital, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1771-0650","authenticated-orcid":false,"given":"Christina","family":"Weismann","sequence":"additional","affiliation":[{"name":"Center for Cleft Lip, Palate and Craniofacial Malformations, Tuebingen University Hospital, 72076 Tuebingen, Germany"},{"name":"Department of Orthodontics, Tuebingen University Hospital, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"LeClair","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON NL2 3G1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6133-9169","authenticated-orcid":false,"given":"Glen","family":"McGee","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON NL2 3G1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1072-0066","authenticated-orcid":false,"given":"Christian F.","family":"Poets","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Tuebingen University Hospital, Calwerstrasse 7, 72076 Tuebingen, Germany"},{"name":"Center for Cleft Lip, Palate and Craniofacial Malformations, Tuebingen University Hospital, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3097-4725","authenticated-orcid":false,"given":"Mirja","family":"Quante","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Tuebingen University Hospital, Calwerstrasse 7, 72076 Tuebingen, Germany"},{"name":"Center for Cleft Lip, Palate and Craniofacial Malformations, Tuebingen University Hospital, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1542\/peds.2010-2615","article-title":"Robin sequence: From diagnosis to development of an effective management plan","volume":"127","author":"Evans","year":"2011","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1001\/jamapediatrics.2016.0796","article-title":"Best Practices for the Diagnosis and Evaluation of Infants With Robin Sequence: A Clinical Consensus Report","volume":"170","author":"Breugem","year":"2016","journal-title":"JAMA Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1750-1172-9-9","article-title":"Birth prevalence and initial treatment of Robin sequence in Germany: A prospective epidemiologic study","volume":"9","author":"Vatlach","year":"2014","journal-title":"Orphanet J. 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