title: The effect of adenotonsillectomy for childhood sleep apnoea on cardiorespiratory control.
abstract: The efficacy of adenotonsillectomy for relieving obstructive sleep apnoea symptoms in children has been firmly established, but its precise effects on cardiorespiratory control are poorly understood. In 375 children enrolled in the Childhood Adenotonsillectomy Trial, randomised to undergo either adenotonsillectomy (n=194) or a strategy of watching waiting (n=181), respiratory rate, respiratory sinus arrhythmia and heart rate were analysed during quiet, non-apnoeic and non-hypopnoeic breathing throughout sleep at baseline and at 7 months using overnight polysomnography. Children who underwent early adenotonsillectomy demonstrated an increase in respiratory rate post-surgery while the watchful waiting group showed no change. Heart rate and respiratory sinus arrhythmia were comparable between both arms. On assessing cardiorespiratory variables with regard to normalisation of clinical polysomnography findings during follow-up, heart rate was reduced in children who had resolution of obstructive sleep apnoea syndrome, while no differences in their respiratory rate or respiratory sinus arrhythmia were observed. Adenotonsillectomy for obstructive sleep apnoea increases baseline respiratory rate during sleep. Normalisation of apnoea-hypopnoea index, spontaneously orviasurgery, lowers heart rate. Considering the small average effect size, the clinical significance is uncertain.
authors.affiliation: School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, Australia.
authors.forename: Mathias
authors.initials: M
authors.lastname: Baumert
authors.affiliation: Dept of Respiratory and Sleep Medicine, Women's and Children's Hospital, Adelaide, Australia.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Pamula
authors.affiliation: Dept of Respiratory and Sleep Medicine, Women's and Children's Hospital, Adelaide, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Martin
authors.affiliation: Dept of Respiratory and Sleep Medicine, Women's and Children's Hospital, Adelaide, Australia; Childrens Research Centre, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
authors.forename: Declan
authors.initials: D
authors.lastname: Kennedy
authors.affiliation: Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
authors.forename: Anand
authors.initials: A
authors.lastname: Ganesan
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Muammar
authors.initials: M
authors.lastname: Kabir
authors.affiliation: Childrens Research Centre, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia; School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Kohler
authors.affiliation: School of Electrical and Electronic Engineering, University of Adelaide, Adelaide, Australia.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Immanuel