Related Experiment Video
Updated: May 2, 2026
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Parental history of adenotonsillectomy is associated with obstructive sleep apnea severity in children with snoring
Emmanouel I Alexopoulos1, George Charitos1, Georgia Malakasioti2
1Sleep Disorders Laboratory, School of Medicine, University of Thessaly and Larissa University Hospital, Larissa, Greece.
Insights
A history of parental adenoidectomy and/or tonsillectomy (AT) increases the risk of moderate-to-severe obstructive sleep apnea (OSA) in children who snore. This risk is higher when tonsillar hypertrophy is also present.
Area of Science:
- Pediatric Sleep Medicine
- Otolaryngology
- Genetics and Family History
Background:
- Obstructive sleep apnea (OSA) is a common condition in children, often associated with snoring.
- Identifying risk factors for pediatric OSA is crucial for timely diagnosis and intervention.
Purpose of the Study:
- To investigate whether a parental history of adenoidectomy and/or tonsillectomy (AT) is a risk factor for moderate-to-severe OSA in children who snore.
- To determine the combined effect of parental AT history and tonsillar hypertrophy on OSA risk.
Main Methods:
- Retrospective review of polysomnography data from 798 children with snoring referred by primary care physicians.
- Analysis included children without pre-existing neuromuscular, genetic, or craniofacial disorders.
- Logistic regression models were used to assess the association between parental AT history and OSA, controlling for other factors.
Main Results:
- 22.1% of children had moderate-to-severe OSA (apnea-hypopnea index >5 episodes/hour).
- A parental history of AT was significantly associated with increased odds of moderate-to-severe OSA (OR, 1.70).
- The combination of tonsillar hypertrophy and parental AT history showed high specificity (84.4%) for identifying children with OSA.
Conclusions:
- Parental history of AT is a significant risk factor for moderate-to-severe OSA in children who snore.
- Children with both tonsillar hypertrophy and parental AT history represent a high-risk subgroup for OSA.
- Prioritization for sleep studies should consider these factors, especially in resource-limited settings.
Objective:
To test the hypothesis that history of adenoidectomy and/or tonsillectomy (AT) in at least 1 of the parents during childhood, is a risk factor for moderate-to-severe obstructive sleep apnea (OSA) (apnea-hypopnea index [AHI] >5 episodes/hour) in the offspring with snoring.
Study Design:
Data of children with snoring who were referred for polysomnography over 12 years by primary care physicians were reviewed.
Results:
Data of 798 children without history of prior AT, neuromuscular, or genetic disorders or craniofacial abnormalities were analyzed. Of these children, 69.3% had tonsillar hypertrophy, 25.8% were obese, 26.8% had at least 1 parent with history of AT, and 22.1% had AHI >5 episodes/hour. Parental history of AT was significantly associated with moderate-to-severe OSA (logit model including sex, tonsillar hypertrophy, obesity, and physician-diagnosed wheezing; OR [95% CI], 1.70 [1.18-2.46]; P < .01). When significant variables from the logit model (tonsillar hypertrophy, obesity, parental history of AT) were considered independently or in combination, tonsillar hypertrophy combined with history of AT in at least 1 of the parents had high specificity (84.4%) and the highest positive likelihood ratio (1.78) for identifying children with AHI >5 episodes/hour.
Conclusions:
Among children with snoring who are referred for polysomnography by primary care physicians, those with tonsillar hypertrophy and parental history of AT have increased risk of moderate-to-severe OSA and represent 1 of the subgroups that should be prioritized for a sleep study in settings with limited resources.
Related Concept Videos
01:21Sleep Apnea
The condition is more prevalent among...
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:28Physical Assessment of the Respiratory Tract I: Health History
Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and...
01:26Tonsillitis II: Management
01:25Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...