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Effects of Adenotonsillectomy on Parent-Reported Behavior in Children With Obstructive Sleep Apnea

Nina Hattiangadi Thomas1,2, Melissa S Xanthopoulos1,3, Ji Young Kim4

  • 1Department of Child and Adolescent Psychiatry and Behavioral Sciences.

Sleep
|February 16, 2017
PubMed

Insights

Adenotonsillectomy significantly improved behavioral issues in children with obstructive sleep apnea syndrome (OSAS). These positive effects on behavior persisted even when sleep-specific symptoms were excluded from the analysis.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Child Psychology

Background:

  • Childhood obstructive sleep apnea syndrome (OSAS) is linked to behavioral abnormalities.
  • Previous studies on OSAS treatment effects on behavior have yielded conflicting results and often lacked randomized designs.
  • Behavioral outcome measures in prior studies may have been confounded by sleep-related symptoms.

Purpose of the Study:

  • To investigate the impact of adenotonsillectomy on behavioral outcomes in children diagnosed with OSAS.
  • To determine if surgical intervention improves behavioral ratings, independent of sleep-specific symptom reporting.

Main Methods:

  • A secondary analysis was conducted on Child Behavior Checklist (CBCL) data from the Childhood Adenotonsillectomy Trial (CHAT).
  • Data from 380 children (aged 5-9 years) with OSAS were analyzed, comparing early adenotonsillectomy (eAT) to watchful waiting with supportive care (WWSC).
  • Analyses were performed with and without the exclusion of sleep-specific items from the CBCL.

Main Results:

  • A high prevalence of behavioral problems was observed at baseline (16.6% in the clinically abnormal range).
  • Children undergoing eAT showed significant improvements in Total Problems, Internalizing Behaviors, Somatic Complaints, and Thought Problems compared to the WWSC group.
  • Behavioral improvements in the eAT group remained significant even after excluding sleep-related items, with notable gains in Total and Other problems.

Conclusions:

  • Adenotonsillectomy is an effective treatment for improving parent-rated behavioral problems in children with OSAS.
  • The positive behavioral effects of adenotonsillectomy extend beyond sleep-specific symptoms.
  • While adenotonsillectomy improved behavior in all children, further research is needed to understand disparities in treatment response among different racial groups.
Abstract

Keywords:
CBCLCHAT.behaviorobstructive sleep apnea

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