Periodic Limb Movements Before and After Adenotonsillectomy in Children With Obstructive Sleep Apnea

Area of Science:

• Pediatric Sleep Medicine
• Respiratory Medicine
• Neurology

Background:

• Obstructive sleep apnea (OSA) is prevalent in children and can be associated with other sleep disorders.
• Periodic limb movements (PLMS) are a common finding in pediatric OSA, potentially impacting sleep quality and daytime function.

Purpose of the Study:

• To determine the prevalence of periodic limb movements (PLMS) in children diagnosed with obstructive sleep apnea (OSA).
• To assess the impact of adenotonsillectomy (AT) on the periodic limb movement index (PLMI) in children with OSA.

Main Methods:

• Retrospective chart review of children with OSA who underwent adenotonsillectomy (AT).
• Analysis of demographic data, obstructive apnea-hypopnea index, and PLMS before and after AT.
• Statistical comparison of PLMI using chi-squared or Fisher's exact test and paired t-test or Wilcoxon signed rank test.

Main Results:

• Elevated PLMI (PLMS > 5 events/h) was observed in 9.8% of 1159 children with OSA.
• Prevalence of elevated PLMI increased significantly with age (preschoolers, grade-schoolers, teenagers) and OSA severity (moderate, severe).
• Following AT, 85% of children experienced resolution of elevated PLMI, with a significant decrease in PLMI from 11.9 to 2.9 events/h (p ≤ 0.001).

Conclusions:

• Elevated PLMI is a common comorbidity in children with OSA undergoing AT.
• Adenotonsillectomy is an effective treatment for resolving PLMI in the majority of children with OSA.