The long-term effect of adenotonsillectomy on changes of position during sleep in pediatric obstructive sleep apnea

초록

Objective/Introduction: Although adenotonsillectomy is known to influence on position change behavior during sleep, the data are limited to short-term follow up results. This study aims to evaluate long-term effect of adenotonsillectomy on changes of position during sleep in pediatric obstructive sleep apnea (OSA). Methods: Children with snoring or sleep apnea who underwent nocturnal standard polysomnography and adenotonsillectomy were retrospectively analyzed in this study. The preoperative and postoperative differences in the frequency of positional changes during sleep and the distribution of sleep positions were investigated. Results: A total of 20 pediatric patients (mean age = 6.6 ± 3.4 years; male:female=15:5) with OSA were included. The mean follow up duration between the preoperative and postoperative polysomnography was 54.5 ± 22.3 months. The respiratory parameters including AHI, minimal oxygen saturation were improved. The total number of positional changes during sleep and positional change index significantly (9.7 ± 5.0 [Pre-op] vs 4.1 ± 2.9 [Post-op]; p < 0.001) decreased after adenotonsillectomy. There was a statistically significant increase in the proportion of sleep time spent in supine position (40.0 ± 19.0%[Pre-op] vs 57.2 ± 32.0% [Post-op]; p = 0.023) on long-term follow up. Conclusion: The tendency to decrease in the frequency of positional changes and increase of supine position proportion during sleep was maintained in long-term follow up after adenotonsillectomy in pediatric OSA.