Sleep characteristics following adenotonsillectomy in children with obstructive sleep apnea syndrome.
OBJECTIVE
To compare the effect of adenotonsillectomy on rapid eye movement (REM)- and non-REM-related respiratory and sleep architecture characteristics in children with obstructive sleep apnea syndrome (OSAS).


METHODS
This prospective study evaluated 36 children (median age, 6.9 years; range, 1.8 to 12.6 years) with OSAS using polysomnography before and a few months after adenotonsillectomy. Primary outcomes included the number of obstructive apnea and hypopnea and arousals per hour of sleep.


RESULTS
At 4.6 months (range, 1 to 16 months) after adenotonsillectomy, there was a significant improvement of all respiratory parameters. The median respiratory disturbance index (RDI) decreased from 4.1/h (range, 0 to 85/h) to 0.9/h (range, 0 to 13/h) after adenotonsillectomy (p < 0.0001). The median non-REM RDI decreased from 3.0/h (range, 0 to 89/h) to 0.4/h (range, 0 to 13/h) [p < 0.001] as compared with REM RDI, which decreased from 7.8/h (range, 0 to 69/h) to 2.3/h (range, 0 to 54/h) after adenotonsillectomy (p < 0.01). Median arousal index decreased following adenotonsillectomy from 17.5/h (range, 7 to 57/h) to 14.0/h (range, 6 to 47/h) [p < 0.03].


CONCLUSIONS
Adenotonsillectomy resulted in a greater improvement in non-REM RDI as compared with REM-RDI, and a decrease in the number of arousals.
Tal
Asher
A
Department of Pediatrics B, Soroka Medical Center, Ben-Gurion University of the Negev, PO Box 151, Beer-Sheva, Israel. ashik@bgumail.bgu.ac.il
Bar
Amir
A
Leiberman
Alberto
A
Tarasiuk
Ariel
A
D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D017286:Polysomnography; D012129:Respiratory Function Tests; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000601:surgery*; D012895:Sleep, REM; D014068:Tonsillectomy