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. Her current studies include:
Sleep Outcomes and Airflow in Robin Sequence (SOAR)
Pediatric sleep apnea causes significant health issues in children including neurocognitive, behavioral, cardiovascular, and metabolic problems. Significant gaps exist 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, in whom common causes of OSA include adenotonsillar hypertrophy and obesity.
As craniofacial anomalies are the most common cause of OSA in infants and young children, Robin sequence (RS) is an ideal model for better understanding OSA in infants.
We are recruiting a cohort of infants, with and without RS. The study will use overnight polysomnography and parent-reported sleep habits to characterize the nature and severity of OSA in infants with RS, and correlate sleep and airflow information with craniofacial anatomic assessment tools. Early pilot data regarding neurodevelopmental, behavioral and cardiac sleep-related outcomes will also be assessed using validated instruments.
Robin Sequence: Descriptive Epidemiology of and Risk Factors for a Multifactorial Developmental Sequence
Robin sequence (RS) is estimated to occur in 1 in 8,500 births. However, its causes are largely unknown, and studies examining risk factors and exposures that potentially lead to RS are limited.
We are addressing 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 this interdisciplinary expert panel, which is developing a screening tool for and treatment algorithm for neonates with airway obstruction.