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Early Surgery Reduces Psychiatric and Learning Disorder Risk in Pediatric Sleep-Disordered Breathing

Daniel J Campbell1,2, W Jack Palmer1,2, Leonard E Estephan1,2

  • 1Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.

The Laryngoscope
|October 16, 2025
PubMed

Insights

Early surgical intervention for pediatric sleep-disordered breathing (SDB) significantly lowers the risk of neuropsychiatric and learning disorders. Untreated or non-surgical management increases these risks compared to surgery.

Area of Science:

  • Pediatric medicine
  • Sleep medicine
  • Neuroscience

Background:

  • Pediatric sleep-disordered breathing (SDB) is linked to adverse neurodevelopmental outcomes.
  • The impact of intervention type and timing on these outcomes requires further elucidation.

Purpose of the Study:

  • To investigate if intervention type and timing for pediatric SDB influence the risk of neuropsychiatric and learning disorders.
  • To compare outcomes between surgical, non-surgical, and untreated SDB management.

Main Methods:

  • Retrospective cohort study (January 2016-March 2025) using TriNetX.
  • Propensity score matching (1:1) for untreated, surgical, and non-surgical pediatric SDB cohorts.
  • Analysis of anxiety, depressive, eating, behavioral, and learning disorders at 1 and 5 years post-intervention.

Main Results:

  • No treatment and non-surgical management were associated with significantly higher risks of neuropsychiatric and learning disorders compared to surgery at 1 year.
  • Early surgery (within 6 months) showed a trend towards reduced risks for anxiety, eating, behavioral, and learning disorders.
  • Similar trends were observed at 5-year follow-up.

Conclusions:

  • Early surgical intervention for pediatric SDB is associated with better neuropsychiatric and learning disorder outcomes.
  • Delayed surgery, non-surgical management, or no treatment increases these risks.
  • Prospective trials are needed to validate these findings.
Abstract

Keywords:
obstructive sleep apneapediatricsquality of lifesleepsurgical treatment of obstructive sleep apnea

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