Objective: To compare the polygraphic parameters in children with adenotonsillar hypertrophy (ATH) with vs without obstructive sleep apnea (OSA).
Design: Prospective controlled study.
Setting: Hospital-based pediatric otolaryngology practice.
Patients: Children with ATH.
Interventions: The children enrolled in the study underwent polysomnography. According to the apnea index (AI) (a patient who has at least 1 episode of apnea per hour of sleep is considered to have apnea), they were classified as having ATH with OSA or ATH without OSA.
Main outcome measures: We evaluated polysomnography parameters to describe the macrostructure of sleep (sleep efficiency, nonrapid eye movement stages 1-4, and rapid eye movement) and the microstructure of sleep (using electroencephalogram results and movement arousals) and respiratory events.
Results: Twenty children were classified as having ATH with OSA and 17 as having ATH without OSA. We found no significant differences in sleep macrostructure and microstructure between the ATH groups with vs without OSA. Apnea-hypopnea indices (AHI), respiratory disturbance events, hypopnea events in rapid eye movement and AHI, AI, respiratory disturbance events, obstructive events, hypopnea events, the duration of obstructive events, and hypopnea events during nonrapid eye movement were more frequent or of longer duration in children with OSA vs those without OSA (P < .05).
Conclusions: Obstructive sleep apnea should be considered a disorder on the continuum of ATH. To our knowledge, our results clearly and for the first time demonstrate that more severe respiratory disturbances seem to be important risk factors for ATH to develop into OSA in children.