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The Impact of Adenotonsillectomy on Sleep and Behavior of Children with Obstructive Sleep Apnea

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Adenotonsillar hypertrophy (ATHt) is a common cause of chronic airway obstruction (UAO) in children and may cause obstructive sleep apnea syndrome (OSAS). Surgical correction in the form of Adenotonsillectomy (AdTyb) may significantly improve the sleep and behavior patterns of children, and enhance their quality of life. To test the effect of adenotonsillectomy on sleep and behavioral disorders in children with adenotonsillar hypertrophy. Prospective observational study; children ≤ 14 years diagnosed with symptomatic adenotonsillar hypertrophy planned for surgery were included. Parents were asked to complete Connor’s revised parent rating scale and Children’s sleep habit questionnaire pre-operatively and 3 months after surgery. This was done to evaluate the children’s sleep habits, disturbances and behavior. A total of 77 children were included in the study. The age range was 4 – 14 years. Fifty-two were male and rest, female. There was a significant reduction in Sleep score after surgery (mean pre-operative sleep score 51.3 ± 8.9 vs. post-operative 37.29 ± 7.1; p value < 0.001). Similarly, there was a statistically significant improvement in the behaviour score also after surgery (mean pre-operative behavior score 28.96 ± 9.8 vs. post-operative 23.13 ± 7.9; p value < 0.001). The sleep and behaviour scores were not related to the age or gender of the participants. Adenotonsillar hypertrophy causes documentable sleep disturbances and obstructive sleep apnea leading to neurobehavioral issues in children. The standard of care is surgery which leads to significant improvement in these aspects and quality of life.

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References

  1. Watkinson JC, Clarke RW (2018) Scott-Brown’s Otorhinolaryngology and Head and Neck Surgery. Eighth Edition 2(27):293–306

    Google Scholar 

  2. Bonuck KA, Chervin RD, Cole TJ et al (2011) Prevalence and persistence of sleep disordered breathing symptoms in young children:a 6 year population based cohort study. Sleep 34(7):875–884

    Article  Google Scholar 

  3. Amin RS, Kimball TR, Bean JA, Jeffries J, Willging JP, Cotton RT et al (2002) Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. Am J Respir Crit Care Med 165:1395–1399

    Article  Google Scholar 

  4. Gozal D (1998) Sleep-disordered breathing and school performance in children. Pediatrics 102:616–620

    Article  CAS  Google Scholar 

  5. Tran KD, Nguyen CD, Weedon J et al (2005) Child behavior and quality of life in pediatric obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 131(1):52–57

    Article  Google Scholar 

  6. Chervin RD, Archbold KH, Dillon JE et al (2002) Inattention, hyperactivity, and symptoms of sleep-disordered breathing. Pediatrics 109(3):449–456

    Article  Google Scholar 

  7. Gottlieb DJ, Vezina RM, Chase C et al (2003) Symptoms of sleep-disordered breathing in 5-year old children are associated with sleepiness and problem behaviours. Pediatrics 112(4):870–877

    Article  Google Scholar 

  8. Bourke RS, Anderson V, Yang JS et al (2011) Neurobehavioural function is impaired in children with all severities of sleep disordered breathing. Sleep Med 12(3):222–229

    Article  Google Scholar 

  9. Flanary VA (2003) Long-term effect of adenotonsillectomy on quality of life in pediatric patients. Laryngoscope 113(10):1639–1644

    Article  Google Scholar 

  10. Mitchell RB, Kelly J, Call E, Yao N (2004) Long term changes in quality of life after surgery for pediatric obstructive sleep apnea. Arch Otolaryngol Head and Neck Surg 130(4):409–412

    Article  Google Scholar 

  11. Marcus CL, Greene MG, Carroll JL (1998) Blood pressure in children with obstructive sleep apnea. Am J Respir Crit Care Med 157:1098–1103

    Article  CAS  Google Scholar 

  12. Shahar E, Whitney CW, Redline S et al (2001) Sleep-disordered breathing and cardiovascular disease. Cross-sectional results ofthe sleep heart health study. Am J Respir Crit Care Med 163:19–25

    Article  CAS  Google Scholar 

  13. Stone J, Malone PS, Atwill D, Mc Grigor V, Hill CM (2008) Symptoms of sleep-disordered breathing in children with nocturnal enuresis. J Pediatr Urol 4:197–202

    Article  Google Scholar 

  14. Firoozi F, Batniji R, Aslan AR, Longhurst PA, Kogan BA (2006) Resolution of diurnal incontinence and nocturnal enuresis after adenotonsillectomy in children. J Urol 175:1885–1888

    Article  Google Scholar 

  15. Leiberman A, Stiller-Timor L, Tarasiuk A, Tal A (2006) The effect of adenotonsillectomy on children suffering from obstructive sleep apnea syndrome (OSAS): the Negev perspective. Int J Pediatr Otorhinolaryngol 70:1675–1682

    Article  Google Scholar 

  16. Beebe DW (2006) Neurobehavioral morbidity associated with disordered breathing during sleep in children: a comprehensive review. Sleep 29:1115–1134

    Article  Google Scholar 

  17. Wei JL, Bond J, Mayo MS, Smith HJ, Reese M, Weatherly RA (2007) Improved behavior and sleep after adenotonsillectomy in children with sleep-disordered breathing: Long-term follow-up. Arch Otolaryngol—Head Neck Surg 133(10):974

    Article  Google Scholar 

  18. De Luca CG, Pacheco-pereira C, Aydinoz S, Bhattacharjee R, Tan H-L, Kheirandish-Gozal L et al (2015) Adenotonsillectomy complications: a meta analysis. Pediatrics 136(4):702–718. https://doi.org/10.1542/peds.2015-1283

    Article  Google Scholar 

  19. Smith DF, Spiceland CP, Ishman SL, Engorn BM, Donohue C, Park PS et al (2017) Admission criteria for children with obstructive sleep apnoea after adenotonsillectomy: Considerations for cost. J Clin Sleep Med 13(12):1463–1472

    Article  Google Scholar 

  20. Umlauf MG, Chasens ER (2003) Bedwetting—not always what it seems: a sign of sleep-disordered breathing in children. J Spec Pediatr Nurs 8:22–30

    Article  Google Scholar 

  21. Hjalmas K, Arnold T, Bower W et al (2004) Nocturnal enuresis: an international evidence based management strategy. J Urol 171:2545–2561

    Article  CAS  Google Scholar 

  22. Somuk BT, Bozkurt H, Göktaş G, Demir O, Gürbüzler L, Eyibilen A (2016) Impact of adenotonsillectomy on ADHD and nocturnal enuresis in children with chronic adenotonsillar hypertrophy. Am J Otolaryngol—Head Neck Med Surg 37(1):27–30

    Google Scholar 

  23. Marcus CL, Moore RH, Rosen CL, Giordani B, Taylor HG et al (2013) A randomized trial of adenotonsillectomy for child hood sleep apnea. N Engl J Med 368(25):2366–2376

    Article  CAS  Google Scholar 

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Authors

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Dr.Arya Ajith and Dr.Siddharth Panikkar collected and analysed data. Dr. Renuka Balu analysed data and prepared manuscript and shall act as the corresponding author. Dr. Madhumita designed the study, edited and reviewed the manuscript.

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Correspondence to Renuka Balu.

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The study was conducted after getting approval from the institutional ethics committee.IEC-AIMS-2017-ENT-310.

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Ajith, A., Balu, R., Kumar, M. et al. The Impact of Adenotonsillectomy on Sleep and Behavior of Children with Obstructive Sleep Apnea. Indian J Otolaryngol Head Neck Surg 74, 329–333 (2022). https://doi.org/10.1007/s12070-021-02593-x

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  • DOI: https://doi.org/10.1007/s12070-021-02593-x

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