title: Measuring sleep quality after adenotonsillectomy in pediatric sleep apnea.
abstract: OBJECTIVE
  The aim of this study was to demonstrate postoperative changes in sleep quality in children with obstructive sleep apnea (OSA), using both conventional sleep staging and electrocardiogram-based cardiopulmonary coupling (CPC) analysis. The hypothesis is that being electroencephalography (EEG)-independent, CPC may detect changes in sleep quality that traditional sleep architecture analysis cannot.
  
  
  METHODS
  Retrospective outcome research.
  
  
  METHODS
  We included 37 children (aged 6.89 ± 2.76 years, 28 male) with OSA who underwent adenotonsillectomy, and analyzed standard polysomnography and CPC parameters from a full-night study before and after adenotonsillectomy. High-frequency coupling (HFC) and low-frequency coupling (LFC) were used as indices of stable and unstable sleep, respectively.
  
  
  RESULTS
  Adenotonsillectomy led to a significant change in CPC parameters (HFC, 50.3 ± 16.1% to 56.1 ± 14.7%, P = .03; LFC, 35.1 ± 14.5% to 27.3 ± 13.0%, P = .003), which was paralleled by improvements in the apnea-hypopnea (12.7 ± 13.7 to 1.0 ± 0.8, P < .001) and arousal index (20.8 ± 11.5 to 9.9 ± 3.9, P < .001). Polysomnographic sleep stage parameters other than the arousal index did not reflect postoperative resolution of OSA.
  
  
  CONCLUSIONS
  In pediatric OSA, postoperative improvement of sleep quality is more readily discernible by CPC analysis than EEG-based sleep staging. The CPC analysis may have potential advantages in the assessment of sleep quality in pediatric populations.
authors: Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul, South Korea.
authors: Seung Hoon
authors: SH
authors: Lee
authors: Ji Ho
authors: JH
authors: Choi
authors: Il Ho
authors: IH
authors: Park
authors: Sang Hag
authors: SH
authors: Lee
authors: Tae Hoon
authors: TH
authors: Kim
authors: Heung Man
authors: HM
authors: Lee
authors: Hee-Kwon
authors: HK
authors: Park
authors: Robert J
authors: RJ
authors: Thomas
authors: Chol
authors: C
authors: Shin
authors: Chang-Ho
authors: CH
authors: Yun
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004562:Electrocardiography / Q000379:methods; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D017286:Polysomnography / Q000379:methods; D011182:Postoperative Care; D011300:Preoperative Care; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000601:surgery*; D012894:Sleep Stages; D014068:Tonsillectomy / Q000379:methods*