title: Quality of life after adenotonsillectomy for children with sleep-disordered breathing: a linear mixed model analysis.
abstract: OBJECTIVE
  To study changes in quality of life (QoL) after adenotonsillectomy (T&A) in children with sleep-disordered breathing (SDB), and to elucidate discrepancies in QoL improvements after T&A in children of different gender, age, adiposity status, and disease severity.
  
  
  METHODS
  Children aged 2-18 years were recruited. All children had SDB-related symptoms and underwent preoperative full-night polysomnography (PSG). Caregivers completed the first obstructive sleep apnea 18-items questionnaire (OSA-18) prior to T&A and the second OSA-18 survey within 3 months after surgery. Disease severity was defined as primary snoring (apnea/hypopnea index, AHI < 1), mild obstructive sleep apnea (OSA) (5 > AHI ≥ 1), and moderate-to-severe OSA (AHI ≥ 5). Discrepancies in OSA-18 score changes after T&A for different groups were assessed using the linear mixed model.
  
  
  RESULTS
  In total, 144 children were enrolled (mean age, 7.0 ± 3.6 years; 76% boy). The OSA-18 total score changes after surgery were not significantly different by gender (boys vs. girls), age group (≥ 6 years vs. < 6 years), or adiposity (obese vs. non-obese). The OSA-18 total score changes after surgery differed by disease severity (primary snoring vs. moderate-to-severe OSA, P = 0.004; mild OSA vs. moderate-to-severe OSA, P = 0.003). Children with moderate-to-severe OSA had greater improvement in OSA-18 total score after surgery than those with mild OSA or primary snoring.
  
  
  CONCLUSIONS
  Children with SDB had QoL improvement after T&A, as documented by OSA-18 score changes. The QoL improvement after T&A for SDB children increased as disease severity increased, and the improvement was not affected by gender, age, or adiposity.
authors: Department of Otolaryngology, China Medical University Hospital, Taipei branch, Taiwan, ROC; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan, ROC.
authors: Chia-Hsuan
authors: CH
authors: Lee
authors: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan, ROC; Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan, ROC; Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, ROC.
authors: Kun-Tai
authors: KT
authors: Kang
authors: Sleep Center, National Taiwan University Hospital, Taipei, Taiwan, ROC; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan, ROC.
authors: Wen-Chin
authors: WC
authors: Weng
authors: Sleep Center, National Taiwan University Hospital, Taipei, Taiwan, ROC; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC.
authors: Pei-Lin
authors: PL
authors: Lee
authors: Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, ROC; Sleep Center, National Taiwan University Hospital, Taipei, Taiwan, ROC. Electronic address: hsuwc@ntu.edu.tw.
authors: Wei-Chung
authors: WC
authors: Hsu
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000601:surgery*; D011795:Surveys and Questionnaires; D014068:Tonsillectomy
keywords: Adenoidectomy; Child; Polysomnography; Quality of life; Sleep apnea syndromes; Tonsillectomy