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Published on: December 6, 2016
The Impact of Adenotonsillectomy on Sleep and Behavior of Children with Obstructive Sleep Apnea
Arya Ajith1, Renuka Balu1, Madhumita Kumar1
1Department Of ENT Amrita Institute of Medical Sciences Kochi, Kerala Kochi, India.
Insights
Adenotonsillar hypertrophy (ATHt) causes sleep and behavioral issues in children. Adenotonsillectomy (AdTyb) surgery significantly improves these symptoms, enhancing children's quality of life.
Area of Science:
- Otolaryngology
- Pediatric Sleep Medicine
- Pediatric Behavioral Health
Background:
- Adenotonsillar hypertrophy (ATHt) is a primary cause of pediatric upper airway obstruction (UAO).
- ATHt can lead to obstructive sleep apnea syndrome (OSAS), impacting sleep and behavior.
- Surgical intervention, adenotonsillectomy (AdTyb), is a common treatment for symptomatic ATHt.
Purpose of the Study:
- To evaluate the impact of adenotonsillectomy on sleep disturbances and behavioral issues in children with ATHt.
- To assess changes in sleep quality and behavior following AdTyb.
- To determine if AdTyb improves the overall quality of life for affected children.
Main Methods:
- Prospective observational study including 77 children (age 4-14) with symptomatic ATHt.
- Parents completed validated questionnaires (Connor's revised parent rating scale, Children's sleep habit questionnaire) pre-operatively and 3 months post-operatively.
- Sleep and behavior scores were analyzed to determine the effect of adenotonsillectomy.
Main Results:
- Significant reduction in sleep disturbance scores post-adenotonsillectomy (mean 51.3 to 37.29, p<0.001).
- Statistically significant improvement in behavior scores after surgery (mean 28.96 to 23.13, p<0.001).
- No correlation found between sleep/behavior scores and participant age or gender.
Conclusions:
- Adenotonsillar hypertrophy significantly contributes to sleep disturbances and neurobehavioral problems in children.
- Adenotonsillectomy is an effective treatment, leading to substantial improvements in sleep and behavior.
- The surgical correction of ATHt enhances children's quality of life.
Abstract:
Adenotonsillar hypertrophy (ATHt) is a common cause of chronic airway obstruction (UAO) in children and may cause obstructive sleep apnea syndrome (OSAS). Surgical correction in the form of Adenotonsillectomy (AdTyb) may significantly improve the sleep and behavior patterns of children, and enhance their quality of life. To test the effect of adenotonsillectomy on sleep and behavioral disorders in children with adenotonsillar hypertrophy. Prospective observational study; children ≤ 14 years diagnosed with symptomatic adenotonsillar hypertrophy planned for surgery were included. Parents were asked to complete Connor's revised parent rating scale and Children's sleep habit questionnaire pre-operatively and 3 months after surgery. This was done to evaluate the children's sleep habits, disturbances and behavior. A total of 77 children were included in the study. The age range was 4 - 14 years. Fifty-two were male and rest, female. There was a significant reduction in Sleep score after surgery (mean pre-operative sleep score 51.3 ± 8.9 vs. post-operative 37.29 ± 7.1; p value < 0.001). Similarly, there was a statistically significant improvement in the behaviour score also after surgery (mean pre-operative behavior score 28.96 ± 9.8 vs. post-operative 23.13 ± 7.9; p value < 0.001). The sleep and behaviour scores were not related to the age or gender of the participants. Adenotonsillar hypertrophy causes documentable sleep disturbances and obstructive sleep apnea leading to neurobehavioral issues in children. The standard of care is surgery which leads to significant improvement in these aspects and quality of life.
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