Obstructive sleep apnea is a serious, potentially life-threatening condition that is far more common than generally understood. It occurs in all age groups and both genders and it is estimated that as many as 18 million Americans have the condition. A new study assessed the benefits of an adenotonsillectomy for children with sleep apnea. The findings were published in the journal Pediatrics.
For the study, the investigators reviewed data from a randomized, controlled study of adenotonsillectomy for obstructive sleep apnea syndrome. (A randomized, controlled study is one in which the subjects are randomly assigned to receive a treatment, in this case, an adenotonsillectomy (removal of the tonsils and adenoids) for sleep apnea. The aim of the study was to test the theory that children who underwent the surgical procedure had a better quality of life and symptom improvement, compared to the control group. The researchers compared quality of life and symptoms between the surgery group and the control group who were assigned to watchful waiting. They measured whether race, weight, or baseline sleep apnea severity affected changes in quality of life and, symptoms, and severity of sleep apnea.
A total of 453 children aged 5 to 9.9 years with sleep apnea were randomly assigned to undergo adenotonsillectomy or watchful waiting with supportive care. An overnight sleep study known as polysomnography, the Pediatric Quality of Life inventory, the Sleep-Related Breathing Scale of the Pediatric Sleep Questionnaire, the 18-item Obstructive Sleep Apnea Quality of Life instrument, and the modified Epworth Sleepiness Scale were conducted at baseline and seven months. Changes in the quality of life and symptom surveys were compared between the two groups. The effects of race and obesity were factored in.
The investigators found that more significant improvements in most quality of life and symptom severity measurements occurred in the children who underwent an adenotonsillectomy, including all the aforementioned tests. Neither obesity or race effects were found at the study onset; however, some racial differences were found at the end of the study period.
The authors concluded that adenotonsillectomy compared with watchful waiting resulted in significantly greater improvements in quality of life and sleep apnea symptoms.