Abstract
The efficacy of adenotonsillectomy for relieving obstructive sleep apnoea symptoms in children has been firmly established, but its precise effects on cardiorespiratory control are poorly understood.
In 375 children enrolled in the Childhood Adenotonsillectomy Trial, randomised to undergo either adenotonsillectomy (n=194) or a strategy of watching waiting (n=181), respiratory rate, respiratory sinus arrhythmia and heart rate were analysed during quiet, non-apnoeic and non-hypopnoeic breathing throughout sleep at baseline and at 7 months using overnight polysomnography.
Children who underwent early adenotonsillectomy demonstrated an increase in respiratory rate post-surgery while the watchful waiting group showed no change. Heart rate and respiratory sinus arrhythmia were comparable between both arms. On assessing cardiorespiratory variables with regard to normalisation of clinical polysomnography findings during follow-up, heart rate was reduced in children who had resolution of obstructive sleep apnoea syndrome, while no differences in their respiratory rate or respiratory sinus arrhythmia were observed.
Adenotonsillectomy for obstructive sleep apnoea increases baseline respiratory rate during sleep. Normalisation of apnoea–hypopnoea index, spontaneously or via surgery, lowers heart rate. Considering the small average effect size, the clinical significance is uncertain.
Abstract
Adenotonsillectomy for childhood obstructive sleep apnoea increases respiratory rate during sleep http://ow.ly/Dptd300w9Pp
Footnotes
This article has supplementary material available from openres.ersjournals.com
Clinical trials: This study is registered at clinicaltrials.gov with identifier number NCT00560859.
Support statement: M. Baumert holds a fellowship from the Australian Research Council and this project was partly supported by grant ARC DP 110102049. The CHAT study was supported by grants (HL083075, HL083129, UL1-RR-024134 and UL1 RR024989) from the National Institutes of Health. Funding information for this article has been deposited with Open Funder Registry.
Conflict of Interest: None declared.
- Received January 12, 2016.
- Accepted April 23, 2016.
- Copyright ©ERS 2016.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.