Quality-of-life but not behavior improves 48-months post-adenotonsillectomy in children with SDB

Abstract

Background: Long term follow-up studies (>12 months) of changes in behavior and quality-of-life (QoL) in children with sleep disordered breathing (SDB) post-adenotonsillectomy are limited and there is a lack of consensus in the reported findings. The aim of this study was to evaluate children's sleep, QoL and behavior at baseline and 6 months and 48 months post-adenotonsillectomy for clinically diagnosed SDB. Methods: This prospective longitudinal study of children aged 3-12 y recruited from a Children's Hospital otolaryngology clinic compared polysomnographic parameters, behavior (Child Behavior Checklist; CBCL) and QoL (OSA-18) at baseline, 6mths and 48mths post-adenotonsillectomy and compared these parameters to healthy non-snoring controls recruited from the general community at the same time points. Results: Sixty-four children completed sleep, behavior and QoL assessments (SDB ¼ 20M/9F, Controls ¼ 18M/17F) at all three time points. Sleep and ventilatory parameters significantly improved in children with SDB with minimal residual obstruction evident at 48 months post-adenotonsillectomy. Compared to baseline, OSA-18 scores significantly improved post-adenotonsillectomy in children with SDB and were equivalent to the scores of controls at 6 months and 48 months post-AT. No significant improvement was observed in behavior in children with SDB post-adenotonsillectomy over the same time period. Conclusion: Baseline deficits in sleep and QoL in children with SDB were normalized at 6 months post-adenotonsillectomy and gains were maintained at 48 months post-adenotonsillectomy. Children with SDB did not show significant gains in behavior either at 6 months or 48 months post-adenotonsillectomy.