title: Long-Term Improvements in Sleep and Respiratory Parameters in Preschool Children Following Treatment of Sleep Disordered Breathing.
abstract: OBJECTIVE
  Sleep disordered breathing (SDB) in preschool-aged children is common, but long-term outcomes have not been investigated. We aimed to compare sleep and respiratory parameters in preschool children to examine the effects of treatment or non-treatment after 3 years.
  
  
  METHODS
  Children (3-5 years) diagnosed with SDB (n = 45) and non-snoring controls (n = 30) returned for repeat overnight polysomnography (39% of original cohort), 3 years following baseline polysomnography. Children with SDB were grouped according to whether they had received treatment or not. SDB resolution was defined as an obstructive apnea hypopnea index (OAHI) ≤ 1 event/h, no snoring detected on polysomnography and habitual snoring not indicated by parents on questionnaire.
  
  
  RESULTS
  Fifty-one percent (n = 23) of the children with SDB were treated. Overall, SDB resolved in 49% (n = 22), either spontaneously (n = 8) or with treatment (n = 14). SDB remained unresolved in 39% (n = 9) of those treated and 64% (n = 14) of the children who were untreated. Two of the non-snoring controls developed SDB at follow-up. The treated group had significantly lower OAHI (p < 0.01), respiratory disturbance index (p < 0.001), total arousal and respiratory arousal indices (p < 0.01 for both) at follow-up compared with baseline. There were no differences between studies for the untreated group.
  
  
  CONCLUSIONS
  Although treatment resulted in an improvement in indices related to SDB severity, 39% had SDB 3 years following diagnosis. These findings highlight that parents should be made aware of the possibility that SDB may persist or recur several years after treatment. This is relevant regardless of the severity of SDB at baseline and the treatment given.
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia.|Department of Paediatrics, Monash University, Melbourne, Australia.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Walter
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia.|Department of Paediatrics, Monash University, Melbourne, Australia.
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Biggs
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia.
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Nisbet
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia.
authors.forename: Aidan J
authors.initials: AJ
authors.lastname: Weichard
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Hollis
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia.|Melbourne Children's Sleep Centre, Monash Children's, Monash Medical Centre, Melbourne, Australia.|Department of Paediatrics, Monash University, Melbourne, Australia.
authors.forename: Margot J
authors.initials: MJ
authors.lastname: Davey
authors.affiliation: Clinical Sciences Research, Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia.|Melbourne Children's Sleep Centre, Monash Children's, Monash Medical Centre, Melbourne, Australia.|Department of Paediatrics, Monash University, Melbourne, Australia.
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Nixon
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia.|Department of Paediatrics, Monash University, Melbourne, Australia.
authors.forename: Rosemary S C
authors.initials: RS
authors.lastname: Horne
mesh_terms: D000233:Adenoidectomy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017286:Polysomnography / Q000706:statistics & numerical data; D012119:Respiration; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*; D012891:Sleep Apnea Syndromes / Q000503:physiopathology* / Q000601:surgery*; D011795:Surveys and Questionnaires; D014068:Tonsillectomy; D016896:Treatment Outcome
keywords: adenotonsillectomy; obstructive sleep apnea; pediatric; polysomnography; respiratory; sleep