Behavioral consequences of children with sleep-disordered breathing after adenotonsillectomy
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ORIGINAL ARTICLE
Behavioral consequences of children with sleep‑disordered breathing after adenotonsillectomy Ji Yoon Kim1 · Chang Ho Lee1 · Hyoung‑Mi Kim1,2 Received: 22 July 2016 / Accepted: 3 March 2017 © Children’s Hospital, Zhejiang University School of Medicine 2018
Abstract Background Adenotonsillectomy (AT) has been an effective treatment for sleep-disordered breathing (SDB) in children, and several studies described the risk of postoperative weight gain and obesity in children treated with AT. The present study aimed to evaluate behavioral improvements in children with SDB one year after adenotonsillectomy and to investigate an influence of postoperative weight gain on behaviors. Methods The study included 170 children aged 5–11 years who underwent adenotonsillectomy for SDB and 150 controls. Body mass index percentile was obtained for age and gender, and parental sleep-related breathing disorder (SRBD) questionnaire was used to assess the severity of SDB. Psychological assessment was performed pre- and post-adenotonsillectomy using standardized questionnaires including strength and difficulties questionnaire, children’s depression inventory and screen for child anxiety-related emotional disorder. Results The mean age of 170 patients was 7.7 ± 1.5 years with 73 (42.9%) girls and 97 (57.1%) boys. The mean follow-up period were 15.4 ± 2.7 months. The patients had shown significant improvements in SDB scores as well as in questionnairebased behavioral problems after adenotonsillectomy. The odds of a child being overweight were significantly increased after adenotonsillectomy. Less improvements in hyperactivity and conduct problems were observed in the patients with older ages, higher SRBD scores, and overweight/obesity at 1-year follow-up after adenotonsillectomy. Conclusion These data suggest that abnormal behavioral outcomes should be evaluated postoperatively, which potentially could be reduced with the early adenotonsillectomy and adequate postoperative weight control. Keywords Obesity · Obstructive sleep apnea · Pediatric · Snoring · Tonsillectomy
Introduction The prevalence of obstructive sleep apnea (OSA) in the pediatric population is currently estimated at 3% of all children and sleep-disordered breathing (SDB) has been reported around 12% of children [1–4]. Long-term adverse effects on the cardiovascular, neurocognitive, and somatic growth consequences are well characterized in childhood OSA. Regardless of the severity of symptoms, behavioral problems are relatively prevalent in children with OSA, and the lack of * Hyoung‑Mi Kim [email protected] 1
Otorhinolaryngology Department, CHA University, Seongnam, Korea
Otorhinolaryngology Department, CHA Bundang Medical Center, CHA University, 351 Yatap‑dong, Bundang‑gu, Seongnam‑si, Gyeonggi‑do 463‑712, Korea
2
correlation between the severity index by polysomnography and neurobehavioral outcomes has been assumed to be due to the influence of other environmental and genetic interactions or insufficient sleep [5]. Recent evidence sug
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