title: Improved behavior and sleep after adenotonsillectomy in children with sleep-disordered breathing: long-term follow-up.
abstract: OBJECTIVE
  To determine whether previously published changes are maintained over time in children after adenotonsillectomy for sleep-disordered breathing using the validated Pediatric Sleep Questionnaire (PSQ) and the Conners Parent Rating Scale-Revised: Short Form (CPRS-R:S).
  
  
  METHODS
  Prospective, nonrandomized interventional study.
  
  
  METHODS
  Ambulatory surgery center affiliated with an academic medical center.
  
  
  METHODS
  Long-term follow-up data were available (ranging from 2.4 to 3.6 years after adenotonsillectomy) for 44 of the 71 patients who completed our initial study comparing PSQ and CPRS-R:S data before and 6 months after surgery.
  
  
  METHODS
  Parents completed the PSQ and CPRS-R:S at least 2 years after surgery.
  
  
  METHODS
  Follow-up PSQ data and long-term changes in age- and sex-adjusted T scores for all 4 CPRS-R:S behavior categories (oppositional behavior, cognitive problems or inattention, hyperactivity, and the attention-deficit/hyperactivity disorder [ADHD] index) were determined for each patient. Linear mixed models were used to analyze the data.
  
  
  RESULTS
  Globally, across time, most variables remained below baseline levels (P < .05). There was a significant increase in PSQ scores during follow-up, but over this period they did not reach baseline levels. Comparing short-term with long-term follow-up, the Conners scores in all behavioral categories did not increase significantly (ADHD index, P = .61; cognitive problems or inattention, P = .02; hyperactivity, P < .001; and oppositional behavior, P < .001). The ADHD index at long-term follow-up was not different from that at baseline, a finding that might be attributable to the high degree of variability in this measure.
  
  
  CONCLUSIONS
  Improvements in sleep experienced by children after adenotonsillectomy for sleep-disordered breathing were not as great 2.5 years after surgery as they were 6 months after surgery but were still significant compared with baseline levels. Improvements in behavior were maintained in all categories of the Conners scores except for the ADHD index.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 3010, Kansas City, KS 66160, USA. jwei@kumc.edu
authors.forename: Julie L
authors.initials: JL
authors.lastname: Wei
authors.forename: Justin
authors.initials: J
authors.lastname: Bond
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Mayo
authors.forename: Holly J
authors.initials: HJ
authors.lastname: Smith
authors.forename: Matt
authors.initials: M
authors.lastname: Reese
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weatherly
mesh_terms: D000234:Adenoids / Q000601:surgery*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000601:surgery*; D014068:Tonsillectomy; D016896:Treatment Outcome