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Quality of life of children with sleep-disordered breathing treated with adenotonsillectomy

Published online by Cambridge University Press:  27 September 2010

S M Powell ,
M Tremlett  and
D A Bosman
S M Powell*
Affiliation:
Department of Otolaryngology, James Cook University Hospital, Middlesbrough, UK
M Tremlett
Affiliation:
Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
D A Bosman
Affiliation:
Department of Otolaryngology, James Cook University Hospital, Middlesbrough, UK
*
Address for correspondence: Mr S M Powell, Department of Otolaryngology, James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK Fax: (0)1642 282756 E-mail: [email protected]
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Abstract

Objective:

To assess the quality of life of UK children with sleep-disordered breathing undergoing adenotonsillectomy, by using the Obstructive Sleep Apnoea 18 questionnaire and determining score changes and effect sizes.

Design:

Prospective, longitudinal study.

Setting:

The otolaryngology department of a university teaching hospital in Northern England.

Participants:

Twenty-eight children for whom adenotonsillectomy was planned as treatment for sleep-disordered breathing, and who had either a clinical history consistent with obstructive sleep apnoea or a polysomnographic diagnosis.

Main outcome measure:

The Obstructive Sleep Apnoea 18 questionnaire, a previously validated, disease-specific quality of life assessment tool; changes in questionnaire scores and effect sizes were assessed.

Methods:

The Obstructive Sleep Apnoea 18 questionnaire was administered to each child's parent pre-operatively, then again at the follow-up appointment. Questionnaire scores ranged from 1 to 7. Score changes were analysed using the paired t-test; effect sizes were calculated using 95 per cent confidence intervals.

Results:

Complete data were obtained for 22 children (mean age, 61 months). Ten had undergone pre-operative polysomnography. Twenty-one children underwent adenotonsillectomy (one underwent tonsillectomy). Median follow up was eight weeks (interquartile range, six to 11 weeks). Following surgery, the overall mean score improvement was 2.6 (p < 0.0001) and the mean effect size 2.4 (95 per cent confidence interval 1.9 to 2.8). There were significant improvements in each of the individual questionnaire domains, i.e. sleep disturbance (mean score change 3.9, p < 0.0001), physical suffering (2.2, p < 0.0001), emotional distress (2.0, p = 0.0001), daytime problems (1.8, p = 0.0001) and caregiver concerns (2.6, p < 0.0001).

Conclusion:

In these children with sleep-disordered breathing treated by adenotonsillectomy, Obstructive Sleep Apnoea 18 questionnaire results indicated significantly improved mean score changes and effect sizes across all questionnaire domains, comparing pre- and post-operative data.

Keywords

TonsillectomyAdenoidectomySleep-Disordered Breathing
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 2 , February 2011 , pp. 193 - 198
Copyright
Copyright © JLO (1984) Limited 2010

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Footnotes

Presented in part at the British Association of Paediatric Otolaryngology Meeting, 12 September 2008, Epsom, UK.

References

1Ali, JA, Stradling, JR. Epidemiology and natural history of sleep disordered breathing in children. In: Loughlin, GM, Carroll, JL, Marcus, CL, eds. Sleep and Breathing in Children: a Developmental Approach. New York: Marcel Dekker, 2000;555–74Google Scholar
2Nixon, GM, Brouillette, RT. Sleep 8: paediatric obstructive sleep apnoea. Thorax 2005;60:511–16CrossRefGoogle ScholarPubMed
3Carroll, JL, McColley, SA, Marcus, CL, Curtis, S, Loughlin, GM. Inability of clinical history to distinguish primary snoring from obstructive sleep apnea syndrome in children. Chest 1995;108:610–18CrossRefGoogle ScholarPubMed
4Capdevila, OS, Kheirandish-Gozal, L, Dayyat, E, Gozal, D. Pediatric obstructive sleep apnea: complications, management, and long-term outcomes. Proc Am Thorac Soc 2008;5:274–82CrossRefGoogle ScholarPubMed
5Clarke, RW. The causes and effects of obstructive sleep apnoea in children. In: Graham, JM, Scadding, GK, Bull, PD, eds. Pediatric ENT. Heidelberg: Springer, 2007;141–51Google Scholar
6Sohn, H, Rosenfeld, RM. Evaluation of sleep-disordered breathing in children. Otolaryngol Head Neck Surg 2003;128:344–52CrossRefGoogle ScholarPubMed
7de Serres, LM, Derkay, C, Astley, S, Deyo, RA, Rosenfeld, RM, Gates, GA. Measuring quality of life in children with obstructive sleep disorders. Arch Otolaryngol Head Neck Surg 2000;126:1423–9CrossRefGoogle ScholarPubMed
8Georgalas, C, Tolley, N, Kanagalingam, J. Measuring quality of life in children with adenotonsillar disease with the Child Health Questionnaire: a first U.K. study. Laryngoscope 2004;114:1849–55CrossRefGoogle ScholarPubMed
9Georgalas, C, Babar-Craig, H, Arora, A, Narula, A. Health outcome measurements in children with sleep disordered breathing. Clin Otolaryngol 2007;32:268–74CrossRefGoogle ScholarPubMed
10Franco, RA, Rosenfeld, RM, Rao, M. First place – resident clinical science award 1999. Quality of life for children with obstructive sleep apnea. Otolaryngol Head Neck Surg 2000;123:9–16CrossRefGoogle ScholarPubMed
11Goldstein, NA, Fatima, M, Campbell, TF, Rosenfeld, RM. Child behavior and quality of life before and after tonsillectomy and adenoidectomy. Arch Otolaryngol Head Neck Surg 2002;128:770–5CrossRefGoogle ScholarPubMed
12Mitchell, RB, Kelly, J, Call, E, Yao, N. Quality of life after adenotonsillectomy for obstructive sleep apnea in children. Arch Otolaryngol Head Neck Surg 2004;130:190–4CrossRefGoogle ScholarPubMed
13Mitchell, RB, Kelly, J. Quality of life after adenotonsillectomy for SDB in children. Otolaryngol Head Neck Surg 2005;133:569–72CrossRefGoogle ScholarPubMed
14Tran, KD, Nguyen, CD, Weedon, J, Goldstein, NA. Child behavior and quality of life in pediatric obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2005;131:52–7CrossRefGoogle ScholarPubMed
15Mitchell, RB, Kelly, J, Call, E, Yao, N. Long-term changes in quality of life after surgery for pediatric obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2004;130:409–12CrossRefGoogle ScholarPubMed
16Flanary, VA. Long-term effect of adenotonsillectomy on quality of life in pediatric patients. Laryngoscope 2003;113:1639–44CrossRefGoogle ScholarPubMed
17Mitchell, RB, Kelly, J. Outcome of adenotonsillectomy for severe obstructive sleep apnea in children. Int J Pediatr Otorhinolaryngol 2004;68:1375–9CrossRefGoogle ScholarPubMed
18Mitchell, RB, Kelly, J. Adenotonsillectomy for obstructive sleep apnea in obese children. Otolaryngol Head Neck Surg 2004;131:104–8CrossRefGoogle ScholarPubMed
19Baldassari, CM, Mitchell, RB, Schubert, C, Rudnick, EF. Pediatric obstructive sleep apnea and quality of life: a meta-analysis. Otolaryngol Head Neck Surg 2008;138:265–73CrossRefGoogle ScholarPubMed
20Mitchell, RB. Adenotonsillectomy for obstructive sleep apnea in children: outcome evaluated by pre- and postoperative polysomnography. Laryngoscope 2007;117:1844–54CrossRefGoogle ScholarPubMed