Persistence of obstructive sleep apnea syndrome in children after adenotonsillectomy

Objective To investigate the relative contribution of various risk factors to the surgical outcome of adenotonsillectomy for obstructive sleep apnea syndrome in children. Study design Children (n = 110; mean age, 6.4 +/- 3.9 years) underwent two polysomnographie evaluations before and after adenotonsillectomy. In addition, 22 control children were studied. History for allergy and family history of sleep-disordered breathing was taken before each polysomnographic evaluation. Results Significant changes in sleep stage percentages and sleep fragmentation were found in the postsurgery study compared with the presurgery study; 25% of the children had apnea/hypopnea index (Lambda HI) <= 1, 46% had AIII > 1 and < 5, and 29% had AHI >= 5 in the postsurgery study. The frequency of subjects with AHI < 1 after surgery was significantly lover among obese subjects (P < .05). Comparison between the children who had Lambda HI <= 1 after surgery and 22 control children shoved complete normalization of sleep architecture after surges. Conclusions Adenotonsillectomy yields improvements in respiratory abnormalities in children with obstructive sleep apnea syndrome. Complete normalization occurs in only 25% of the patients. Obesity and Lambda HI at diagnosis are the major determinant for surgical outcome. When normalization of respiratory measures occurs after surgery, normalization of sleep architecture will also ensue.