title: Effect of Adenotonsillectomy on Parent-Reported Sleepiness in Children with Obstructive Sleep Apnea.
abstract: To describe parental reports of sleepiness and sleep duration in children with polysomnography (PSG)-confirmed obstructive sleep apnea (OSA) randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC) in the ChildHood Adenotonsillectomy Trial (CHAT). We hypothesized children with OSA would have a larger improvement in sleepiness 6 mo following eAT compared to WWSC.
  
  
  
  Parents of children aged 5.0-9.9 y completed the Epworth Sleepiness Scale modified for children (mESS) and the Pediatric Sleep Questionnaire-Sleepiness Subscale (PSQ-SS). PSG was performed at baseline and at 7-mo endpoint. Children underwent early adenotonsillectomy or WWSC.
  
  
  
  The mESS and PSQ-SS classified 24% and 53% of the sample as excessively sleepy, respectively. At baseline, mean mESS score was 7.4 ± 5.0 (SD) and mean PSQ-SS score was 0.44 ± 0.30. Sleepiness scores were higher in African American children; children with shorter sleep duration; older children; and overweight children. At endpoint, mean mESS score decreased by 2.0 ± 4.2 in the eAT group versus 0.3 ± 4.0 in the WWSC group (P < 0.0001); mean PSQ-SS score decreased 0.29 ± 0.40 in eAT versus 0.08 ± 0.40 in the WWSC group (P < 0.0001). Despite higher baseline sleepiness, African American children experienced similar improvement with adenotonsillectomy than other children. Improvement in sleepiness was weakly associated with improved apnea-hypopnea index or oxygen desaturation indices, but not with change in other polysomnographic measures.
  
  
  
  Sleepiness assessed by parent report was prevalent; improved more after eAT than after WWSC; and was not strongly predicted by sleep disturbances identified by PSG.
  
  
  
  Childhood Adenotonsillectomy Study for Children with OSA (CHAT). ClinicalTrials.gov Identifier #NCT00560859.
authors: Department of Pediatrics, Saint Louis University, St. Louis, MO.
authors: Shalini
authors: S
authors: Paruthi
authors: Saint Louis University Center for Outcomes Research, St. Louis, MO.
authors: Paula
authors: P
authors: Buchanan
authors: Division of Sleep Medicine, Brigham and Women's Hospital, Boston, MA.
authors: Jia
authors: J
authors: Weng
authors: Department of Neurology and Sleep Disorders Center, University of Michigan, Ann Arbor, MI.
authors: Ronald D
authors: RD
authors: Chervin
authors: Department of Otolaryngology, University of Texas Southwestern, Dallas, Texas.
authors: Ronald B
authors: RB
authors: Mitchell
authors: Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI.
authors: Dawn
authors: D
authors: Dore-Stites
authors: Boston Children's Hospital, Boston, MA.
authors: Anjali
authors: A
authors: Sadhwani
authors: Division of Respiratory Diseases, Boston Children's Hospital, Boston, MA.
authors: Eliot S
authors: ES
authors: Katz
authors: Departments of Otolaryngology-Head and Neck Surgery and Pediatrics, Albert Einstein College of Medicine, Bronx, NY.
authors: John
authors: J
authors: Bent
authors: Department of Pediatrics, Rainbow Babies & Children's Hospital, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH.
authors: Carol L
authors: CL
authors: Rosen
authors: Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors: Susan
authors: S
authors: Redline
authors: Department of Pediatrics, Sleep Center, Children's Hospital of Philadelphia; University of Pennsylvania, Philadelphia, PA.
authors: Carole L
authors: CL
authors: Marcus
mesh_terms: D000233:Adenoidectomy; D002648:Child; D002675:Child, Preschool; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010290:Parents; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000601:surgery*; D012894:Sleep Stages; D014068:Tonsillectomy; D016896:Treatment Outcome; D057832:Watchful Waiting
keywords: Epworth Sleepiness Scale; OSA; OSAS; Pediatric Sleep Questionnaire; adenotonsillectomy; apnea-hypopnea index; pediatric; polysomnogram; sleepiness