About the SLUMBRS II Study

The Issue

To reduce the numbers of babies dying from ‘cot death’ the government produced national guidelines advising that babies should sleep on their back, called the ‘Back to Sleep’ campaign. We do not know if this is the best advice for babies with cleft palate.

Babies with cleft palate have an increased risk of breathing problems whilst asleep due to problems with how their nose, mouth and throat have formed, meaning that they have a small airway to breathe through and their tongue falls backwards during sleep. Some doctors and nurses caring for babies with cleft palate, feel from their experience that these babies are better sleeping on their side, rather than on their back.

It is important that a baby’s heart, lungs and brain receive the right amount of oxygen to work normally whilst asleep. Regular blockage of a baby’s airway during sleep can cause problems with oxygen reaching the lungs and then the bloodstream and organs. If the amount of oxygen in the blood regularly drops during sleep it can place a strain on the heart and lungs, which can cause problems with health, growth, brain development and learning at the time and in the future. Babies with cleft palate are particularly at risk of these problems as their airways are already small.

Currently, doctors and nurses do not know the best advice to give parents regarding the safest sleeping position for a baby with cleft palate.

The Feasibility Study

In 2015 a team of Specialist Cleft nurses from the North West (Manchester and Liverpool) and the North East (Newcastle and Leeds) took part in a feasibility study to determine how to best answer the question about sleeping position of infants with cleft palate (Side Lying and Upper airways Maintenance in Babies Requiring Surgery for cleft palate (SLUMBRS)).

This study was led by Prof Iain Bruce from The Royal Manchester Children’s Hospital and funded by the National Institute for Health Research (NIHR). The SLUMBRS feasibility study found that there are local differences in the advice given to parents of children with cleft palate regarding the sleeping position, with some Cleft Centres advising side lying and some back lying sleeping position.

We have published a feasibility study that has shown that parents and nurses think this is an important unanswered question, and the advice given to parents differs depending on where they live.

Find out more about results of the feasibility study.


We will work with local cleft palate teams to ask parents of a large number of babies with cleft palate to take part in the three-year study.

Parents will be asked to agree to their baby being randomly chosen to sleep on their back or side. During one night of testing at 1 month of age, we will estimate blood oxygen levels during sleep using a sensor attached to the baby’s toe that records changes in the amount of oxygen in the blood. Find out more about this equipment here. Recordings will be done at home by parents after they have been trained by the nurses to use the machine.

You can find detailed information on the study protocol as published in the British Medical Journal or on the Clinical Trials website.

Regular updates about the study will be published on this hub as well as on pages of participating centres. Find your local SLUMBRS II contact here.


If you have any questions about the study or would like to know more, please get in touch via [email protected]

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