Adenotonsillectomy for Obstructive Sleep Apnea in Obese Children

OBJECTIVE: To study changes in sleep behavior and quality of life in obese children after adenotonsillectomy for obstructive sleep apnea. Study design and setting Prospective study at the University of New Mexico Children's Hospital. METHODS: Children who met inclusion criteria and had a respiratory distress index (RDI) greater than 5 were enrolled in the study and underwent adenotonsillectomy. All children underwent preoperative and postoperative full-night polysomnography. Age- and gender-specific percentile BMI was recorded at the time of polysomnography. Caregivers were asked to complete an OSA-18 quality of life survey prior to polysomnography and a second survey within 6 months of surgery. Scores from preoperative and postoperative polysomnography and OSA-18 surveys were compared using the paired Student's t test. RESULTS: The study population included 30 children. Twenty-six children (86%) were male. The mean age of the children at the time of inclusion in the study was 9.3 years; range, 3.0 to 17.2. The mean preoperative BMI was 28.6 (range, 19.2 to 47.1) and the mean postoperative BMI was 27.9 (range, 17.8 to 27.9). A 2-tailed paired t test showed that this difference is not statistically significant (P = 0.06). The mean preoperative RDI was 30.0 and the mean postoperative RDI was 11.6 (P < 0.001). The preoperative mean total OSA-18 score was 78.2 and the postoperative mean total score was 39.8 (P < 0.001). CONCLUSION: Obese children with OSA who undergo adenotonsillectomy show a marked improvement in RDI and in quality of life with no change in BMI. However, in the majority of children, OSA does not resolve.