Evaluation of sleeping parameters with peripheral arterial tonometry in childhood sleep apnea and snoring: a clinical feasibility study

Eur Arch Otorhinolaryngol. 2023 Aug;280(8):3783-3789. doi: 10.1007/s00405-023-07948-4. Epub 2023 Apr 7.

Abstract

Purpose: The influence of adenoidectomy ± tonsillotomy/tonsillectomy on objective sleep parameters in children with Obstructive Sleep Apnea (OSA) was determined with the help of ambulatory polygraphy (WatchPat300®, Neucomed Ltd., Vienna, Austria). These results were compared with the findings of the OSA-18 questionnaire.

Methods: 27 children treated with adenoidectomy ± tonsillotomy/tonsillectomy at the Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, were consecutively included in this prospective clinical trial. Pre- and postoperative objective sleeping parameters were assessed with outpatient polygraphy (WatchPat300®) and subjective symptoms with the OSA-18 questionnaire.

Results: Most of the children presented with severe OSA (41%, 11/27). The mean preoperative AHI was 10.2 (± 7.4). Postoperatively it declined to 3.7 (± 1.8; p < 0.0001). Following surgery 19/24 (79%) children had a mild OSA and 8/24 (21%) a moderate OSA. None of the children suffered from severe OSA anymore after surgery. The postoperative AHI did not correlate with the age (p = 0.3), BMIp (p = 0.6) or extent of surgery (p = 0.9). The mean postoperative OSA-18 survey score was significantly lower than the preoperative one (70.7 ± 26.7 vs. 34.5 ± 10.5; p < 0.0001). The postoperative OSA-18 questionnaire showed a normal survey score below 60 in 23/24 (96%) of the children.

Conclusions: The WatchPat® device might be a feasible way for objective assessment of pediatric OSA in children older than 3 years. Adenoidectomy ± tonsillotomy/tonsillectomy caused a significant decrease of the AHI in children with OSA. This effect was especially pronounced in children with severe OSA and none of the children had persistent severe OSA after surgery.

Keywords: Adenotomy; Obstructive sleep apnoea syndrome; Polygraphy; Respiratory disturbance index; Tonsillectomy; Tonsillotomy.

Publication types

  • Clinical Trial

MeSH terms

  • Adenoidectomy / methods
  • Child
  • Child, Preschool
  • Feasibility Studies
  • Humans
  • Prospective Studies
  • Quality of Life
  • Sleep
  • Sleep Apnea Syndromes* / complications
  • Sleep Apnea, Obstructive* / diagnosis
  • Sleep Apnea, Obstructive* / etiology
  • Sleep Apnea, Obstructive* / surgery
  • Snoring / diagnosis
  • Snoring / etiology
  • Snoring / surgery
  • Tonsillectomy* / methods