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Does REM AHI Predict Persistent OSA After Pediatric Adenotonsillectomy?

Caroline M Fields1, Nicolas S Poupore1, Jenna H Barengo1

  • 1Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.

The Annals of Otology, Rhinology, and Laryngology
|January 23, 2024
PubMed

Insights

Preoperative REM AHI does not reliably predict persistent obstructive sleep apnea (OSA) in children after adenotonsillectomy. Further research is needed to guide clinical decisions regarding REM AHI in pediatric OSA management.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Obstructive sleep apnea (OSA) is common in children.
  • Adenotonsillectomy is a primary treatment for pediatric OSA.
  • The role of REM AHI in predicting treatment outcomes is unclear.

Purpose of the Study:

  • To evaluate the association between preoperative REM AHI and persistent OSA post-adenotonsillectomy in children.
  • To determine if REM-predominant OSA predicts treatment failure.

Main Methods:

  • Retrospective chart review of 353 children undergoing adenotonsillectomy for OSA.
  • Exclusion of children with craniofacial/neuromuscular disorders or tracheostomy.
  • Analysis of preoperative and postoperative polysomnograms, defining persistent OSA as oAHI ≥ 1.5 events/hour.

Main Results:

  • 65.7% of children had persistent OSA post-surgery.
  • No significant difference in preoperative REM AHI or related metrics between persistent and resolved OSA groups.
  • No significant difference in persistence rates between REM-predominant and REM-independent OSA.

Conclusions:

  • Preoperative REM AHI appears to be a poor predictor of OSA persistence after adenotonsillectomy in children.
  • Further studies are required to clarify the clinical utility of REM AHI in managing pediatric OSA.
Abstract

Keywords:
REMadenotonsillectomyobstructive sleep apneapolysomnogram

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