Dr. Kelly Evans’s research focuses on sleep and breathing in children with craniofacial conditions. In particular, she is studying risk factors for the development of airway obstruction and sleep disturbance in children born with micrognathia, glossoptosis and cleft palate, also known as Robin sequence (RS).
Pediatric sleep apnea causes significant health issues in children including neurocognitive, behavioral, cardiovascular and metabolic problems. But there are significant gaps in our understanding of obstructive sleep apnea (OSA) in children with craniofacial conditions, as they are often excluded from studies evaluating OSA in typical children. As craniofacial anomalies are the most common cause of OSA in infants and young children, RS is an ideal model for better understanding OSA in infants.
The Evans Lab's current studies include:
Sleep and Ecological Factors in Infants with Craniofacial Conditions (ECOSleep)
The ECOSleep study’s goal is to learn more about the sleep of infants with certain craniofacial conditions and find out who are more at risk for sleep and breathing problems. The study team is investigating links between a novel parent-report infant sleep questionnaire and the gold standard (polysomnography) in children at high risk for early OSA, and obtaining innovative information on parent sleep. A total of 28 infants (with and without craniofacial conditions) and their parents are being recruited to answer these questions.
Robin Sequence: Descriptive Epidemiology of and Risk Factors for a Multifactorial Developmental Sequence
RS is estimated to occur in 1 in 8500 births. However, its causes are largely unknown, and studies examining risk factors and exposures that potentially lead to RS are limited.
The Evans lab is beginning to address this gap by conducting a case control study using birth certificate records and hospital discharge databases for children born in Washington State, with the goal of identifying perinatal factors that are potentially associated with RS. The research, which will be among the first epidemiologic studies focusing specifically on RS, will contribute to improved understanding of the condition’s pathogenesis, and will potentially identify a subpopulation of children with RS for which to focus further etiologic inquiry.
Workgroup on Neonatal Upper Airway Obstruction
Evans is an inaugural member of the Workgroup on Neonatal Upper Airway Obstruction, an interdisciplinary expert panel that has developed a screening tool for and treatment algorithm for neonates with airway obstruction. Her collaborative team, including partners in neonatology and otolaryngology, has implemented this algorithm at Seattle Children’s and is continuously working to improve care for infants with early sleep and airway problems.