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Effect of Adenotonsillectomy on Parent-Reported Sleepiness in Children with Obstructive Sleep Apnea

Shalini Paruthi1, Paula Buchanan2, Jia Weng3

  • 1Department of Pediatrics, Saint Louis University, St. Louis, MO.

Sleep
|August 30, 2016
PubMed

Insights

Early adenotonsillectomy significantly improved sleepiness in children with obstructive sleep apnea (OSA) compared to watchful waiting. Parental reports of sleepiness decreased more after surgery, indicating a benefit of early intervention for pediatric OSA.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Clinical Trials Research

Background:

  • Obstructive sleep apnea (OSA) is common in children and can lead to significant sleepiness.
  • Parental reports of sleepiness are crucial for assessing the impact of OSA and treatment effectiveness.
  • The ChildHood Adenotonsillectomy Trial (CHAT) investigated the effects of early adenotonsillectomy versus watchful waiting in children with OSA.

Purpose of the Study:

  • To evaluate parental reports of sleepiness and sleep duration in children with PSG-confirmed OSA.
  • To compare the effectiveness of early adenotonsillectomy (eAT) versus watchful waiting with supportive care (WWSC) on sleepiness.
  • To test the hypothesis that children with OSA experience greater improvement in sleepiness after eAT compared to WWSC.

Main Methods:

  • Parents of children aged 5-9.9 years completed validated sleepiness questionnaires (mESS, PSQ-SS).
  • Polysomnography (PSG) was conducted at baseline and 7-month follow-up.
  • Children were randomized to either eAT or WWSC groups.

Main Results:

  • A significant proportion of children with OSA reported excessive sleepiness at baseline (24-53%).
  • Sleepiness scores significantly decreased in the eAT group compared to the WWSC group at endpoint (P < 0.0001 for both mESS and PSQ-SS).
  • Improvement in sleepiness was weakly correlated with PSG findings, suggesting parent-reported sleepiness is a key outcome.

Conclusions:

  • Parent-reported sleepiness is prevalent in children with OSA and improves significantly after early adenotonsillectomy.
  • Early adenotonsillectomy is more effective than watchful waiting in reducing sleepiness in pediatric OSA.
  • The study highlights the importance of parental perception in assessing treatment outcomes for childhood OSA.
Abstract

Keywords:
Epworth Sleepiness ScaleOSAOSASPediatric Sleep Questionnaireadenotonsillectomyapnea-hypopnea indexpediatricpolysomnogramsleepiness

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