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The effect of adenotonsillectomy for childhood sleep apnoea on cardiorespiratory control

Mathias Baumert1, Yvonne Pamula2, James Martin2

  • 1School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, Australia.

ERJ Open Research
|October 13, 2016
PubMed

Insights

Adenotonsillectomy for childhood obstructive sleep apnea increases respiratory rate during sleep. Resolution of sleep apnea, via surgery or natural means, lowers heart rate, though clinical significance remains uncertain.

Area of Science:

  • Pediatric Sleep Medicine
  • Cardiorespiratory Physiology
  • Otolaryngology

Background:

  • Adenotonsillectomy is effective for obstructive sleep apnea (OSA) symptoms in children.
  • Its impact on cardiorespiratory control during sleep is not well understood.

Purpose of the Study:

  • To investigate the effects of adenotonsillectomy on cardiorespiratory control in children with OSA.
  • To compare changes in respiratory rate, respiratory sinus arrhythmia, and heart rate between surgical and watchful waiting groups.

Main Methods:

  • Utilized overnight polysomnography in 375 children from the Childhood Adenotonsillectomy Trial.
  • Analyzed respiratory rate, respiratory sinus arrhythmia, and heart rate during sleep at baseline and 7 months.
  • Randomized children to either adenotonsillectomy (n=194) or watchful waiting (n=181).

Main Results:

  • Children undergoing adenotonsillectomy showed increased respiratory rate post-surgery; the watchful waiting group did not change.
  • Heart rate and respiratory sinus arrhythmia were similar between groups.
  • Resolution of OSA (spontaneous or surgical) was associated with reduced heart rate, but not respiratory rate or sinus arrhythmia.

Conclusions:

  • Adenotonsillectomy increases baseline sleep respiratory rate in children with OSA.
  • Resolution of OSA, irrespective of treatment, lowers heart rate.
  • The clinical significance of these findings, given the small effect size, requires further investigation.

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