Effects of Obstructive Sleep Apnea in Children as a Result of Adenoid and/or Adenotonsillar Hypertrophy on Maternal Psychologic Status (original) (raw)
Related papers
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2020
Recurrent infection and enlargement of adenoid and tonsil tissue can lead to problems of recurrent otitis media, sinusitis, obstructive sleep apnea disorder and orthognathic dysfunction along with altered facial growth. Various other important consequences are behavioural disorders, day time sleepiness, poor school performance and COR pulmonale. 2,3 As a consequence, adenotonsillectomy has become one of the most frequently performed surgeries in paediatric age group within otolaryngology speciality. Although the indications for adenotonsillectomy are well established since decades, very few studies had focused on impact of surgery on quality of life of the patients. 4 There are various methods available to assess to quality of life in children including generic health related ABSTRACT Background: Recurrent adeno-tonsillitis can lead to problems of secretory otitis media/OSA/sinusitis and thus adenotonsillectomy is one of the most frequent done surgery in children. The present study aimed to evaluate the impact of adenoidectomy or adenotonsillectomy on the quality of life of children using obstructive sleep apnoea-18 score. Methods: A prospective study was conducted in the Department of Otorhinolaryngology, Head and Neck Surgery at Ananta Institute of Medical Science, Rajsamand between January 2017 to December 2019. A total of 60 patients of age group 4 to 15 years were included in study who were undergoing adenoidectomy or adenotonsillectomy. All patients were evaluated by using 'obstructive sleep apnea-18' (OSA-18) preoperatively and 6 months post-operative period for impact on quality of life on children after surgery. Results: 60 children with a mean age of 8.6 years were evaluated. The most frequent indication for surgery was recurrent adeno-tonsillitis and obstructive sleep apnoea for adenoid hypertrophy. The total mean score of initial OSA-18 was 85.34, following surgery at 6 months, the total mean score was reduced to 31.23 (p value <0.001). Similarly, there was reduction in mean score of individual domains after surgery which was statically significant (p<0.001). Conclusions: Our study concludes that on evaluation of children with adenoid hypertrophy using OSA-18 preoperative and 6 months post-operative period, showed adenoidectomy or adenotonsillectomy has positive impact on paediatric quality of life.
The Laryngoscope, 2007
Objective: To compare changes in behavior after adenotonsillectomy in children with either mild sleep‐disordered breathing (SDB) or obstructive sleep apnea (OSA).Study Design: Prospective cohort study.Methods: Children at the University of New Mexico Children's Hospital, Albuquerque with mild SDB or OSA were included in the study. All children underwent preoperative polysomnography before adenotonsillectomy. Mild SDB was defined as an apnea‐hypopnea index (AHI) less than 5 or an apnea index (AI) less than 1. OSA was defined as an AHI 5 or greater or an AI 1 or greater. Pre‐ and postoperative scores from the Behavioral Assessment System for Children (BASC) survey were compared using repeated measures analysis of variance.Results: The mean preoperative AHI for children with mild SDB (n = 17) was 3.1 (range, 1.7–4.7), and for children with OSA (n = 23) it was 25.3 (range, 10.0–48.0). The mean preoperative BASC scores for children with mild SDB were not significantly different from ...
Effect of Adenotonsillectomy on Parent-Reported Sleepiness in Children With Obstructive Sleep Apnea
Sleep, 2016
To describe parental reports of sleepiness and sleep duration in children with polysomnography (PSG)-confirmed obstructive sleep apnea (OSA) randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC) in the ChildHood Adenotonsillectomy Trial (CHAT). We hypothesized children with OSA would have a larger improvement in sleepiness 6 mo following eAT compared to WWSC. Parents of children aged 5.0-9.9 y completed the Epworth Sleepiness Scale modified for children (mESS) and the Pediatric Sleep Questionnaire-Sleepiness Subscale (PSQ-SS). PSG was performed at baseline and at 7-mo endpoint. Children underwent early adenotonsillectomy or WWSC. The mESS and PSQ-SS classified 24% and 58% of the sample as excessively sleepy, respectively. At baseline, mean mESS score was 7.4 ± 5.0 (SD) and mean PSQ-SS score was 0.44 ± 0.30. Sleepiness scores were higher in African American children; children with shorter sleep duration; older children; and overweight children. ...
DSM-IV Diagnoses and Obstructive Sleep Apnea in Children Before and 1 Year After Adenotonsillectomy
Journal of the American Academy of Child and Adolescent Psychiatry, 2007
Objectives-Obstructive sleep apnea, a common indication for adenotonsillectomy in children, has been linked to behavioral morbidity. We assessed psychiatric diagnoses in children before and after adenotonsillectomy and examined whether baseline sleep apnea predicted improvement after surgery. Method-Subjects of this prospective cohort study were children aged 5.0-12.9 years-old who had been scheduled for adenotonsillectomy (n = 79), or care for unrelated surgical conditions (n=27, among whom 13 had surgery after baseline assessment). Prior to intervention and one year later, subjects underwent structured diagnostic interviews and polysomnography. The main outcome measure was frequency of DSM-IV attention and disruptive behavior disorder diagnoses (A&DBDs) at baseline and follow-up. Results-At baseline, A&DBDs were diagnosed in 36.7% of adenotonsillectomy subjects and 11.1% of controls (p<.05); attention-deficit/hyperactivity disorder was found in 27.8% and 7.4%, respectively (p<.05). One year later, group differences were non-significant, A&DBDs were diagnosed in only 23.1% (p<.01), and 50% of subjects with baseline attention-deficit/hyperactivity disorders no longer met diagnostic criteria. Obstructive sleep apnea on polysomnography at baseline did not predict concurrent psychiatric morbidity or later improvement. Conclusions-Attention and disruptive behavior disorders, diagnosed by DSM-IV criteria, were more common before clinically-indicated adenotonsillectomy than one year later. Surgery may be associated with reduced morbidity even among subjects lacking polysomnographic evidence of obstructive sleep apnea.
Effects of adenotonsillectomy on parent-reported behavior in children with obstructive sleep apnea
Sleep, 2017
The childhood obstructive sleep apnea syndrome (OSAS) is associated with behavioral abnormalities. Studies on the effects of OSAS treatment on behavior are conflicting, with few studies using a randomized design. Further, studies may be confounded by the inclusion of behavioral outcome measures directly related to sleep. The objective of this study was to determine the effect of adenotonsillectomy on behavior in children with OSAS. We hypothesized that surgery would improve behavioral ratings, even when sleep symptom items were excluded from the analysis. This was a secondary analysis of Child Behavior Checklist (CBCL) data, with and without exclusion of sleep-specific items, from the Childhood Adenotonsillectomy Trial (CHAT). CBCL was completed by caregivers of 380 children (7.0+1.4 [range 5-9] years) with OSAS randomized to early adenotonsillectomy (eAT) versus 7 months of watchful waiting with supportive care (WWSC). There was a high prevalence of behavioral problems at baseline;...
Sleep, 2001
Study Objectives: To identify predictors of sleep-disordered breathing (SDB) in children who have undergone self-reported tonsillectomy and/or adenoidectomy (TA). Design: Observational study of pediatric participants in a longitudinal genetic-epidemiological cohort study of SDB Setting: Community-based; studies conducted at participants' homes Participants: 577 children age <18 (10.8±4.2 SD) years; 53% female; 48% Black; 76% with a family member identified with SDB Interventions: NA Measurements and Results: Medical history assessed by questionnaire. Physical measures made directly. SDB was assessed with overnight inhome cardio-respiratory monitoring. 10% of children (n=60) had had aTA 5.5±4.6 yrs previously. An Apnea-Hypopnea Index (AHI, events/hr) ≥5 was found in a higher proportion of children with a reported TA than in children with no history of out surgery (35% vs. 13.7%, p<.001). A TA was reported more frequently for non-Blacks than for Blacks (13.6% non-Blacks, 6.9% Blacks, p=.02). Among children who had a TA, significant predictors of SDB (AHI≥5) were: Black ethnicity (SDB in 57% vs. 24% of Blacks vs. non-Blacks; adjusted odds ratio (OR): 3.85; 95% CI: 1.11, 13.33) and obesity (OR 3.98; 95% CI: 1.05, 15.08). SDB also tended to be greater in children with a family member with SDB (OR 2.87; 95% CI: 0.65, 12.07). Conclusions: Black children were less likely to have undergone TA but more likely to have SDB after TA surgery. These findings underscore the need to follow children post-TA and for evidence-based studies that define the role of TA in the management of pediatric adenotonsillar disease.
Quality of Life After Adenotonsillectomy for Obstructive Sleep Apnea in Children
Archives of Otolaryngology–Head & Neck Surgery, 2004
Objective: To study changes in quality of life in children after adenotonsillectomy for obstructive sleep apnea (OSA) documented by full-night polysomnography. Design and Setting: Prospective study of children with OSA at the University of New Mexico Children's Hospital, Albuquerque. Methods: Caregivers for children were asked to complete the OSA-18 quality of life survey prior to polysomnography. Children who met inclusion criteria and had a respiratory distress index higher than 1 were enrolled in the study and underwent adenotonsillectomy. Caregivers completed a second OSA-18 survey within 6 months of surgery. Scores from the preoperative and postoperative surveys were compared using the paired t test. Results: The study population included 60 children (mean age, 7.1 [range, 3-12] years), of whom 43 (72%) were male and 30 (50%) were younger than 6 years. Fortyseven children (78%) had a respiratory distress index of 10 or higher. The mean interval between the 2 surveys was 126 days. The mean total OSA-18 score was 71.4 before surgery and 35.8 after surgery. The domain with the greatest change in mean score was sleep disturbance, which improved by 11.5. The changes in total score, in the scores for each domain, and for each item of the OSA-18 survey were highly significant (PϽ.002). Conclusions: Children without significant comorbidities show a marked improvement in the domains of sleep disturbance, physical symptoms, emotional symptoms, and daytime functioning as reported by their caregivers after adenotonsillectomy for OSA.
Outcome of adenotonsillectomy for severe obstructive sleep apnea in children
International journal of pediatric otorhinolaryngology, 2004
To study changes in sleep behavior and quality of life in children after adenotonsillectomy for severe obstructive sleep apnea identified by a respiratory distress index > or = 30. Children enrolled in the study underwent adenotonsillectomy and had both pre- and post-operative polysomnography. Caregivers also completed an OSA-18 quality of life survey prior to polysomnography and within 6 months of surgery. Paired Student's t-tests were used to compare pre- and post-operative scores. The study population included 29 children. The mean age was 7.1 years (range 1.4-17.0). The most common comorbidities were obesity, asthma and allergic disease. The mean pre-operative RDI was 63.9 and the mean post-operative RDI was 14.2 (P < .0001). The mean total OSA-18 score before surgery was 77.6 and after surgery was 33.2. The differences in pre- and post-operative OSA-18 total scores and domain scores were significant (P < .0001). Children with severe OSA who undergo adenotonsillecto...
Quality of life and obstructive sleep apnea symptoms after pediatric adenotonsillectomy
Pediatrics, 2015
Data from a randomized, controlled study of adenotonsillectomy for obstructive sleep apnea syndrome (OSAS) were used to test the hypothesis that children undergoing surgery had greater quality of life (QoL) and symptom improvement than control subjects. The objectives were to compare changes in validated QoL and symptom measurements among children randomized to undergo adenotonsillectomy or watchful waiting; to determine whether race, weight, or baseline OSAS severity influenced changes in QoL and symptoms; and to evaluate associations between changes in QoL or symptoms and OSAS severity. Children aged 5 to 9.9 years with OSAS (N = 453) were randomly assigned to undergo adenotonsillectomy or watchful waiting with supportive care. Polysomnography, the Pediatric Quality of Life inventory, the Sleep-Related Breathing Scale of the Pediatric Sleep Questionnaire, the 18-item Obstructive Sleep Apnea QoL instrument, and the modified Epworth Sleepiness Scale were completed at baseline and 7 ...
Sleep related quality of life before and after adenotonsillar surgery in pediatric population
International Journal of Pediatric Otorhinolaryngology, 2014
Sleep disordered breathing (SDB) is a common entity in children with a spectrum of upper airway disorders ranging in severity from primary snoring to obstructive sleep apnea (OSA) . The etiology of SDB is multifactorial and its complex interplay among anatomical, neuromuscular and predisposing genetic factors into disease [6], most common cause of SDB in children is adenotonsillar hypertrophy. Tonsillectomy and adenoidectomy are curative in 85-95% cases . Other causes of SDB include obesity, neuromuscular disorder and craniofacial anomalies .