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Improvement in Central Sleep Apnea Following Adenotonsillectomy in Children

Ryan T Judd1, Babak Mokhlesi2, Andrea Shogan3

  • 1University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.

The Laryngoscope
|July 29, 2021
PubMed

Insights

Adenotonsillectomy (T&A) effectively resolves central sleep apnea (CSA) in most children with obstructive sleep apnea (OSA). Improvement in the microarousal index and older age were linked to better CSA outcomes after T&A.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Central sleep apnea (CSA) in children with obstructive sleep apnea (OSA) is not fully understood.
  • Previous studies on adenotonsillectomy (T&A) for OSA and its effect on CSA have had limitations.
  • Identifying factors influencing CSA improvement post-T&A is crucial for clinical management.

Purpose of the Study:

  • To determine if CSA improves after T&A in children with OSA.
  • To identify factors that mediate the improvement of CSA following T&A.

Main Methods:

  • Retrospective case series of 123 children undergoing T&A for OSA with concurrent CSA.
  • Analysis of preoperative and postoperative polysomnograms within 12 months of T&A.
  • Defined CSA improvement based on changes in the central apnea index (CAI).

Main Results:

  • CSA significantly decreased post-T&A (median CAI from 2.1 to 0.4, P < .001).
  • 26% of patients had residual CSA postoperatively.
  • Improved microarousal index and older age were significantly associated with CSA improvement.

Conclusions:

  • T&A resolves CSA in the majority of pediatric OSA patients.
  • Post-arousal central apneas may contribute to CSA, resolving after T&A.
  • Microarousal index improvement is a key indicator for CSA resolution post-T&A.
Abstract

Keywords:
Central sleep apneaobstructive sleep apneasleep apnea

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