# Association between the habitual lip and tongue posture, clinical characteristics, and sleep-related problems in infants with Trisomy 21

## TL;DR

This study explores how lip and tongue posture, along with clinical traits, relate to sleep issues in infants with Trisomy 21.

## Contribution

It identifies associations between sleep problems, habitual oral posture, and clinical factors in infants with T21.

## Key findings

- Most infants with T21 had good sleep quality, but prematurity was linked to witnessed breathing pauses.
- Unusual sleeping positions were associated with female sex and a tongue posture contained in the mouth.
- Restless sleep was connected to choking episodes in these infants.

## Abstract

To analyze the association of habitual lip and tongue posture and clinical characteristics with sleep-related problems in infants with Trisomy 21 (T21).

This cross-sectional observational study with a non-probabilistic sample included 87 infants with T21 with a mean age of 8.8 months. The infants' parents answered the Brief Infant Sleep Questionnaire (BISQ) and questions about signs and symptoms related to obstructive sleep apnea. The habitual lip and tongue posture was obtained by analyzing videos of the infants' faces. Information on personal data and health history was extracted from medical records, and information about feeding and oral habits was obtained by interviewing the parents. Descriptive analysis approached the infants' sleep data and the association between sleep quality, snoring, witnessed respiratory pauses, unusual sleeping positions, restless sleep, and the other variables, using Pearson's chi-square test with a 5% significance level.

Most infants (82.7%) had good sleep quality. Prematurity was associated with witnessed respiratory pauses; unusual sleeping positions were associated with being a female and with the tongue habitually contained in the oral cavity; and restless sleep was associated with choking.

Prematurity, sex, habitual tongue posture, and choking were associated with the aspects of sleep investigated in infants with T21.

analisar a associação da postura habitual de lábios e de língua e características clínicas com queixas relacionadas ao sono em lactentes com Trissomia do 21 (T21).

trata-se de um estudo observacional transversal, com amostra não probabilística, composta por 87 lactentes com T21, com média de idade de 8,8 meses. Os pais dos lactentes responderam ao Questionário sobre Sono na Criança (BISQ) e a perguntas sobre sinais e sintomas relacionados à apneia obstrutiva do sono. A postura habitual de lábios e língua foi obtida a partir da análise de vídeos da face dos lactentes. Informações referentes a dados pessoais e histórico de saúde foram extraídas dos prontuários e sobre alimentação e hábitos orais foram obtidas por entrevista aos pais. Foi realizada a análise descritiva dos dados referentes ao sono dos lactentes e análise de associação entre qualidade do sono, queixa de ronco, pausas respiratórias presenciadas, adoção de posições incomuns durante o sono e sono agitado e as demais variáveis, por meio do teste Qui-quadrado de Pearson, com nível de significância de 5%.

A maioria dos lactentes (82,7%) apresentou boa qualidade do sono. Houve associação entre prematuridade e relato de pausas respiratórias presenciadas; adotar posições incomuns durante o sono apresentou associação com sexo feminino e com a postura habitual da língua contida na cavidade oral; e sono agitado apresentou associação com queixa de engasgo.

prematuridade, sexo, postura habitual de língua e queixas de engasgos foram fatores associados aos aspectos do sono investigados em lactentes com T21.