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Effect of surgical intervention for mild childhood obstructive sleep apnoea on attention and behavioural outcomes: A

Chun T Au1, Kate C C Chan1, Dennis L Y Lee2

  • 1Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.

Respirology (Carlton, Vic.)
|April 1, 2021
PubMed

Insights

Surgery for mild obstructive sleep apnea (OSA) in children did not improve attention or behavior. While surgical intervention improved sleep study parameters and reduced symptoms, objective measures of attention remained unchanged.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Pediatric Pulmonology

Background:

  • Mild obstructive sleep apnea (OSA) is common in school-aged children.
  • The impact of early surgical intervention versus watchful waiting on inattention and behavioral outcomes in children with mild OSA requires evaluation.

Purpose of the Study:

  • To compare the effects of early surgical intervention (ES) versus watchful waiting (WW) on attention and behavioral outcomes in school-aged children with mild OSA.

Main Methods:

  • A prospective randomized controlled study involved 114 pre-pubertal children (6-11 years) with polysomnography-confirmed mild OSA.
  • Participants were randomized to ES (tonsillectomy with or without adenoidectomy and turbinate reduction) or WW.
  • Primary outcome was the omission T score from Conners' Continuous Performance Test (CPT); secondary outcomes included behavioral assessments, quality of life, symptoms, and polysomnography (PSG) parameters at baseline and 9-month follow-up.

Main Results:

  • No significant differences in CPT parameters or behavioral outcomes were observed between the ES and WW groups.
  • The ES group showed significant reductions in the obstructive apnea-hypopnea index and arousal index compared to the WW group.
  • The ES group also demonstrated significant improvements in OSA-18 total symptom scores, greater weight gain, and increased systolic blood pressure.

Conclusions:

  • Surgical treatment for mild OSA in children did not yield improvements in objective attention measures.
  • Despite improvements in PSG parameters and parent-reported symptoms, early surgery did not translate to enhanced cognitive or behavioral function.
  • Further research may be needed to understand the long-term effects and identify potential benefits of surgical intervention in specific pediatric OSA populations.
Abstract

Keywords:
adenotonsillectomyattentionbehavioural problemsobstructive sleep apnoeapre-pubertal childrensurgical intervention

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