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Respiratory sleep disorders, nasal obstruction and enuresis in children with non-syndromic Pierre Robin sequence


Obstructive sleep apnea is highly prevalent in non-syndromic Pierre Robin sequence patients. Studies have found a probable relationship between obstructive sleep apnea (OSA) and nasal obstruction (NO) and between obstructive sleep apnea and enuresis. Assessment of the relationship between these variables in non-syndromic Pierre Robin sequence patients is scarce.


The present study aims to evaluate the relationship between symptoms of OSA, NO and enuresis, determining the prevalence of symptoms suggestive of these conditions, in schoolchildren with non-syndromic Pierre Robin sequence, and describe the prevalence of excessive daytime sleepiness habitual snoring and voiding dysfunction symptoms associated with enuresis.


This was a prospective analytical cross-sectional study developed at a reference center. Anthropometric measurements and a structured clinical interview were carried out in a sample of 48 patients. The instruments "sleep disorders scale in children” (SDSC), "nasal congestion index questionnaire" (CQ-5), and the "voiding dysfunction symptom score questionnaire" (DVSS) were used. Statistical analysis was performed for p < 0.05.


Positive SDSC scores for OSA and CQ-5 for NO were observed in 38.78% and 16.33%, respectively. Enuresis was reported in 16.33% of children, being characterized as primary in 71.43% and polysymptomatic in 55.55%; according to the DVSS. There was a significant relationship between NO and OSA symptoms (p < 0.05), but no significance was found between OSA symptoms and enuresis, and between NO and enuresis. The prevalence of excessive daytime sleepiness was 12.24% and of habitual snoring, 48.98%. A family history of enuresis, younger age in years and a positive DVSS score were associated with a higher prevalence of enuresis (p < 0.05).


Children with non-syndromic Pierre Robin sequence are at high risk for obstructive sleep apnea symptoms and habitual snoring, with a correlation being observed between nasal obstruction and obstructive sleep apnea symptoms. In addition, the study showed that non-syndromic Pierre Robin sequence, obstructive sleep apnea and nasal obstruction symptoms were not risk factors for enuresis in these patients.


Enuresis; Nasal obstruction; Obstructive sleep apnea; Pierre Robin syndrome.


Área Clínica


Faculdade de odontologia da USP campus Bauru - FOB-USP - São Paulo - Brasil, Hospital de Reabilitação de anomalias craniofaciais da USP - HRAC-USP - São Paulo - Brasil


Fabio Luiz Banhara, Inge Elly Kiemle Trindade, Ivy Kiemle Trindade-Suedam, Marilyse Bragança Lopes Fernandes, Sergio Henrique Kiemle Trindade