Last Updated: 2009-07-21 17:03:39 -0400 (Reuters Health)
NEW YORK (Reuters Health) – While improvements in sleep and behavior in children with sleep-disordered breathing were not as great 2.5 years after adenoidectomy and tonsillectomy as they were 6 months after surgery, the changes were still statistically significant compared to baseline levels.
In a prospective, non-randomized interventional study, Dr. Julie L. Wei and colleagues from the University of Kansas Medical Center, Kansas City, analyzed a previously studied group of children to determine if improvements in sleep and behavior were maintained over time.
Follow-up data were available for 44 of the 71 original study participants, who repeated questionnaires and tests on sleep, behavior, hyperactivity and other topics 6 months and up to 2.5 years after adenotonsillectomy. Results are published in the July issue of the Archives of Otolaryngology-Head and Neck Surgery.
The researchers report that most variables remained below baseline levels across time. Significant increases in Pediatric Sleep Questionnaires scores were observed during follow-up, but they did not reach baseline levels.
"Sleep was still much better at 2.5 years after surgery," Dr. Wei explained in an interview with Reuters Health. "However, factors such as weight gain and gastroesophageal reflux may affect quality of sleep and influence the long-term effects of surgery on sleep."
"Three out of four categories of behavior measures had improvements that were statistically significant compared to baseline: hyperactivity, cognition/inattention, oppositional behavior," Dr. Wei noted. "ADHD index at 2.5 years after surgery was not different compared to baseline; however, this measure is highly variable."
She added that improvements in behavior were greater compared to sleep.
This study did not take into consideration body mass index, which is an important factor in determining long-term benefits. "While we are increasingly recognizing the benefits of adenoidectomy and tonsillectomy in children with enlarged tonsils and adenoids, we are now even more concerned that depending on the patient’s weight, the benefits may not be long-lasting," Dr. Wei explained.
"Overweight and obesity are critical factors in how much a child may continue to snore after successful surgical outcome," she said. "It is important to look at the relationship between increasing weight and how that may influence the benefits gained from surgery for this group of children."
Arch Otolaryngol Head Neck Surg 2009;135:642-646.