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Adenotonsillectomy outcomes in children with sleep apnea and narcolepsy

Sneh Biyani1, Tina D Cunningham2, Cristina M Baldassari3

  • 1Department of Otolaryngology - Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.

International Journal of Pediatric Otorhinolaryngology
|August 14, 2017
PubMed

Insights

Adenotonsillectomy significantly improved daytime sleepiness in children with narcolepsy and mild obstructive sleep apnea (OSA). Most children experienced reduced sleepiness after the procedure, highlighting a potential treatment benefit.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Neurology

Background:

  • Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness.
  • Obstructive sleep apnea (OSA) can exacerbate sleepiness in children with narcolepsy.
  • Adenotonsillectomy is a common surgical intervention for pediatric OSA.

Purpose of the Study:

  • To evaluate the impact of adenotonsillectomy on daytime sleepiness in children diagnosed with narcolepsy and non-severe obstructive sleep apnea (OSA).

Main Methods:

  • A 15-year retrospective case series involving children aged 6-17 with narcolepsy and non-severe OSA.
  • Diagnosis of narcolepsy confirmed by clinical assessment and Multiple Sleep Latency Test (MSLT).
  • Pediatric Epworth Sleepiness Scale (ESS) used to quantify daytime sleepiness pre- and post-adenotonsillectomy.

Main Results:

  • Nine children (mean age 12.1 years) were included; 78% were African American and 66.7% were obese.
  • Mean preoperative ESS was 16.10, significantly decreasing to 10.80 post-surgery (p=0.02).
  • Seven children (78%) reported reduced daytime sleepiness after adenotonsillectomy.

Conclusions:

  • Adenotonsillectomy leads to significant improvements in daytime sleepiness for children with narcolepsy and non-severe OSA.
  • Further research is warranted to understand the prevalence and clinical importance of non-severe OSA in pediatric narcolepsy cases.
Abstract

Keywords:
AdenotonsillectomyDaytime sleepinessNarcolepsyObstructive sleep apneaPolysomnogram

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