The Journal of Pediatrics
Volume 150, Issue 5 , Pages 540-546.e1, May 2007

Adenotonsillectomy Improves Sleep, Breathing, and Quality of Life But Not Behavior

  • Evelyn Constantin, MD

      Affiliations

    • Department of Pediatrics, Montreal Children’s Hospital, McGill University, Montreal, Canada
    • Corresponding Author InformationReprint requests: Dr Evelyn Constantin, Pediatric Sleep Laboratory, Montreal Children’s Hospital, 2300 Tupper Street, C508, Montreal, Quebec H3H 1P3, Canada.
    • ,
  • Andrea Kermack, BSc

      Affiliations

    • Department of Pediatrics, Montreal Children’s Hospital, McGill University, Montreal, Canada
    • ,
  • Gillian M. Nixon, MD

      Affiliations

    • Department of Respiratory and Sleep Medicine, Monash Medical Centre, and the Monash Institute of Medical Research, Monash University, Melbourne, Australia.
    • ,
  • Lee Tidmarsh, MD

      Affiliations

    • Department of Psychiatry, Montreal Children’s Hospital, McGill University, Montreal, Canada
    • ,
  • Francine M. Ducharme, MD

      Affiliations

    • Department of Pediatrics, Montreal Children’s Hospital, McGill University, Montreal, Canada
    • ,
  • Robert T. Brouillette, MD

      Affiliations

    • Department of Pediatrics, Montreal Children’s Hospital, McGill University, Montreal, Canada

Received 13 April 2006; received in revised form 1 December 2006; accepted 19 January 2007.

Objective

To obtain parental perspectives on changes in sleep, breathing, quality of life (QOL), and neurobehavioral measures after adenotonsillectomy.

Study design

This retrospective cohort study comprised otherwise healthy children evaluated for obstructive sleep apnea syndrome (OSAS) from 1993 to 2001. We compared those children who underwent adenotonsillectomy with those children who did not. The parents of 473 children (292 boys) 2 years of age and older were sent questionnaires to evaluate QOL and clinical and behavioral changes. For 94 children 3 years of age and older, behavioral changes were evaluated using the Conners’ Parent Rating Scale-Revised (CPRS-R) for three different periods: pre-operatively/pre-polysomnography, postoperatively/postpolysomnography, and recently.

Results

One hundred and sixty-six questionnaires were returned (35%), 138 of which were complete with written consent provided. Compared with parents of unoperated children, parents of children who had adenotonsillectomy were more likely to report improvements in sleep, breathing, and QOL but not improvements in concentration, school performance, and intellectual or developmental progress. Both short and long term, there were no significant effects of adenotonsillectomy on any of the CPRS-R behavior subscales.

Conclusion

From a parental perspective, adenotonsillectomy frequently improves sleep, breathing, and QOL but does not often improve neurobehavioral outcomes.

Abbreviation: ADHD, Attention deficit hyperactivity disorder, ANOVA, Analysis of variance, CPRS-R, Conners’ Parent Rating Scale-Revised, MOAHI, Mixed obstructive apnea/hypopnea index, OSAS, Obstructive sleep apnea syndrome, QOL, Quality of life

 

 Evelyn Constantin was supported by a fellowship from the Fonds de Recherche en Sante du Quebec, the Montreal Children’s Hospital Research Institute and the Canadian Child Health Clinician Scientist Program. Gillian Nixon was supported by the Alan Ross fellowship of the Department of Pediatrics at the Montreal Children’s Hospital/McGill University.

PII: S0022-3476(07)00098-4

doi:10.1016/j.jpeds.2007.01.026

The Journal of Pediatrics
Volume 150, Issue 5 , Pages 540-546.e1, May 2007

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