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Sleep and Breathing the First Night After Adenotonsillectomy in Obese Children With Obstructive Sleep Apnea

Aliva De1, Temima Waltuch2, Nathan J Gonik3,4

  • 1Division of Respiratory and Sleep Medicine, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|April 30, 2017
PubMed

Insights

Obese children with obstructive sleep apnea (OSA) undergoing adenotonsillectomy (AT) often have residual OSA post-surgery. Careful postoperative monitoring is crucial for these patients.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Anesthesiology

Background:

  • Obstructive sleep apnea (OSA) is prevalent in obese children.
  • Adenotonsillectomy (AT) is a common treatment for pediatric OSA.
  • Limited data exists on postoperative respiratory complications in obese children with OSA post-AT.

Purpose of the Study:

  • To evaluate respiratory characteristics and sleep architecture in obese children with OSA on the night of AT.
  • To identify potential risks and complications associated with the perioperative period.

Main Methods:

  • Prospective study of 20 obese children (8-17 years) with OSA undergoing AT.
  • Baseline and postoperative polysomnography (PSG) were performed.
  • Demographic, clinical, surgical, and anesthetic variables were recorded.

Main Results:

  • 85% of patients exhibited abnormal sleep studies post-AT, similar to baseline.
  • Postoperative obstructive apnea-hypopnea index (oAHI) and SpO2 nadir showed no significant change.
  • Significant decrease in REM sleep and increase in N2 sleep were observed postoperatively.

Conclusions:

  • Obese children with OSA undergoing AT remain at high risk for residual OSA on the night of surgery.
  • Special attention to postoperative monitoring and management is warranted for this population.
Abstract

Keywords:
OSAadenotonsillar hypertrophyadenotonsillectomychildrenobeseobstructive sleep apnea

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