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

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.