What question did this study set out to answer?

This study identifies characteristics in children that predict residual obstructive sleep apnea after adenotonsillectomy. Understanding these predictors can improve follow-up care after surgery.

May 10, 2026

0859 Predictors of Residual Obstructive Sleep Apnea in Children Following Adenotonsillectomy

Key Points

This study identifies characteristics in children that predict residual obstructive sleep apnea after adenotonsillectomy. Understanding these predictors can improve follow-up care after surgery.
Single-center retrospective study conducted from 2021-2024.
Included 370 patients aged 2-18 with AHI scores of 5.1 or higher before and after surgery.
Evaluated variables included age, sex, race, BMI, neck circumference, oxygen saturation metrics, and apnea-hypopnea index scores.
Older age, female sex, non-Caucasian race, and higher BMI predict residual OSA post-adenotonsillectomy.
Logistic regression models indicate that higher BMI and neck circumference significantly increase the odds of AHI >5 post-op.
Identifying pre-op PSG characteristics can help reduce unnecessary follow-up polysomnography.

Abstract

Abstract Introduction Obstructive sleep apnea (OSA) is the most frequently diagnosed pediatric sleep disorder, affecting 3-6% of the 74 million children in the US. Children with moderate to severe sleep apnea, defined by an Apnea-Hypopnea Index (AHI) score of 5.1 or higher, are candidates for adenotonsillectomy. Follow-up polysomnograms (PSG) are frequently ordered following adenotonsillectomy to determine further treatment. The objective of this study was to identify patient and PSG characteristics of children likely to have residual OSA (AHI5) following adenotonsillectomy who benefit from repeat PSG. Methods In this single-center retrospective study, data was collected by reviewing the medical records and PSG REDCap database from 2021-2024. Patients aged 2-18 with two sleep studies; before and after adenotonsillectomy, and a baseline AHI of 5.1 or higher were included. The following variables: age, sex, race, BMI, neck circumference (NC), SpO2 Time 90%, Total 5 post-op are older age, female sex, non-caucasian race, higher BMI, larger NC, higher total AHI and REM AHI, higher DI, lower nadir saturation, higher time 90% SpO2, and higher peak CO2. Logistic regression models (adjusted for age, sex, and race) showed increased Odds Ratio of having AHI5 with BMI, NC, Total and REM AHI, O2 nadir, SpO2 T 90, DI, average and peak CO2. Further analysis is being performed to identify the AHI on pre-op PSG that will predict AHI5 in the post-op PSG. Conclusion Follow-up PSGs are frequently ordered following adenotonsillectomy due to the absence of a standardized protocol that elucidates when follow-up PSGs are warranted with clinical benefit. This study helps determine if follow-up PSGs are warranted in children with OSA following adenotonsillectomy to reduce unnecessary repeat PSGs. As PSGs are expensive to perform and with limited access to Pediatric Sleep Centers across the country, this study will help reduce healthcare costs and improve access for all children. Support (if any)

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Cite This Study

Rooney et al. (Fri,) studied this question.

synapsesocial.com/papers/6a0021e6c8f74e3340f9cdbc https://doi.org/https://doi.org/10.1093/sleep/zsag091.0858

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