ORIGINAL ARTICLE Sleep-disordered breathing in children with craniosynostosis Muslim M. Alsaadi & Shaikh M. Iqbal & Essam A. Elgamal & Mustafa A. Salih & David Gozal Received: 1 February 2012 / Revised: 29 March 2012 / Accepted: 10 April 2012 / Published online: 26 April 2012 # Springer-Verlag 2012 Abstract Background Syndromic craniosynostosis (SC) is associated with a high prevalence of sleep-disordered breathing (SDB). However, it remains unclear whether non-syndromic cranio- synostosis (NSC) is associated with an increased risk for SDB. Setting This study was conducted at a tertiary referral pediatric medical center. Methods A prospective polysomnographic (PSG) evalua- tion was conducted of all children diagnosed with craniosy- nostosis over a 3-year period and who had not undergone previous PSG for SDB-related symptoms. Results Among 14 children fulfilling inclusion criteria, 10 had NSC and 4 were diagnosed with SC (Crouzon syndrome). SDB was present in 50 % of the NSC and in 75 % of SC. No associations emerged between the number of sutures affected and the presence of SDB. Conclusions SDB is highly prevalent not only in SC but also among asymptomatic children with NSC. The diagno- sis of NSC should prompt a diagnostic PSG as a routine component of the clinical evaluation, and PSG findings may aid in the formulation of decisions regarding timing and need for surgical interventions. Keywords Sleep-disordered breathing . Craniosynostosis . Children . Polysomnography Introduction Craniosynostosis refers to either prenatal or postnatal pre- mature fusion of one or more cranial sutures [1], which results from either a primary defect of ossification (primary craniosynostosis) or from failure of brain growth (secondary craniosynostosis). Single-suture craniosynostosis refers to an isolated premature fusion of one cranial suture. Complex or compound craniosynostosis involves two or more cranial sutures. Syndromic craniosynostosis (SC) can be associated with additional congenital anomalies such as choanal atre- sia, cleft lip or palate, maxillary hypoplasia, abnormalities of the tracheobronchial tree, hydrocephalus, and other central nervous system (CNS) malformations along with complex craniosynostosis, and includes, among others, Apert, Crouzon, and Pfeiffer syndromes [2–6]. The overall incidence of single-suture craniosynostosis is approxi- mately 5 in 10,000 live births, although estimates vary [7, 8]. Sagittal synostosis is most common whereas lambdoid is least common. The prevalence of all types of craniosynostosis in different populations varies from 3 to 14/10,000 births [8]. M. M. Alsaadi : S. M. Iqbal Division of Pediatric Respiratory Medicine, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia E. A. Elgamal Division of Neurosurgery, Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia M. A. Salih Division of Pediatric Neurology, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia D. Gozal (*) Department of Pediatrics, Comer Children’ s Hospital, The University of Chicago, 5721 S. Maryland Avenue, MC 8000, Suite K-160, Chicago, IL 60637, USA e-mail: dgozal@uchicago.edu Sleep Breath (2013) 17:389–393 DOI 10.1007/s11325-012-0706-2