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Craniofacial photography and association with sleep-disordered breathing severity in children

  • Pediatrics • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Purpose

Sleep-disordered breathing (SDB) in children has been associated with craniofacial characteristics. Facial photography provides a radiation-free means of estimating facial morphology through facial landmark analysis. Our objective was to determine whether facial analysis provides information about SDB severity. Specifically, we aimed to determine whether facial photographic measurements differ with SDB status, or were associated with SDB severity.

Methods

Single-center cohort of children undergoing overnight polysomnography for assessment of SDB; non-snoring controls were recruited from the community to undergo polysomnography. Standardized front and lateral facial photographs were analyzed according to previously published protocols. Multivariate analysis of variance was used to determine if facial measurements differed between SDB groups and controls. Linear regression was performed to determine if facial measurements were associated with SDB severity.

Results

Seventy-eight children (9 controls, 17 primary snoring, 23 mild SDB, 27 moderate-severe SDB) were included. Facial angles and upper-to-lower face height ratio showed variation between SDB groups (p = 0.038). Facial measurements related to SDB severity, specifically an increased cervicomental angle (p = 0.001), and increased lower-to-upper face height (p = 0.006).

Conclusion

Evaluation of craniofacial features using clinical photography is feasible. Preliminary investigation shows some relationship with SBD severity. Further work is needed to determine if craniofacial photography is useful for stratifying SDB risk in children.

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Funding

GN received a National Health and Medical Research Council Translating Research into Practice Fellowship (2016–2017) that supported this work. RH, GN, and MD received National Health and Medical Research Council project grants APP1010810 and APP1063500 that supported this work.

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Authors and Affiliations

  1. Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia

    Kate Sutherland & Peter A Cistulli

  2. Charles Perkins Centre and Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia

    Kate Sutherland & Peter A Cistulli

  3. The Ritchie Centre, The Hudson Institute of Medical Research and Department of Paediatrics, Monash University, Clayton, Victoria, Australia

    Aidan J Weichard, Margot J Davey, Rosemary SC Horne & Gillian M Nixon

  4. Melbourne Children’s Sleep Centre, Monash Children’s Hospital, Clayton, Victoria, Australia

    Margot J Davey & Gillian M Nixon

Authors
  1. Kate Sutherland
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  2. Aidan J Weichard
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  3. Margot J Davey
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  4. Rosemary SC Horne
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  5. Peter A Cistulli
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  6. Gillian M Nixon
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Corresponding author

Correspondence to Kate Sutherland.

Ethics declarations

All studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All participants gave their informed consent prior to their inclusion in the study.

Conflict of interest

PC has an appointment to an endowed Academic Chair at the University of Sydney that was established from ResMed funding. He has received research support from ResMed, SomnoMed, and Zephyr Sleep Technologies. He is a consultant/adviser to Zephyr Sleep Technologies, ResMed (Narval), and Bayer. He has received speaker fees from ResMed (Narval) and Nox Medical. He has a pecuniary interest in SomnoMed related to a previous role in R&D (2004). All other authors have no conflicts of interest to declare.

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Sutherland, K., Weichard, A.J., Davey, M.J. et al. Craniofacial photography and association with sleep-disordered breathing severity in children. Sleep Breath 24, 1173–1179 (2020). https://doi.org/10.1007/s11325-019-01928-x

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  • DOI: https://doi.org/10.1007/s11325-019-01928-x

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