RT Journal Article
SR Electronic
T1 Persistent respiratory effort after adenotonsillectomy in children with sleep disordered breathing
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP P57
DO 10.1183/23120541.sleepandbreathing-2017.P57
VO 3
IS suppl 1
A1 Jean-Benoit Martinot
A1 Nhat-Nam Le-Dong
A1 Jean-Christian Borel
A1 Stéphane Denison
A1 David Gozal
A1 Jean-Louis Pepin
YR 2017
UL http://openres.ersjournals.com/content/3/suppl_1/P57.abstract
AB Objectives Adenotonsillectomy (AT) markedly improves, but does not necessarily normalize polysomnographic (PSG) findings in children with adenotonsillar hypertrophy and related disordered breathing (SDB), potentially requiring follow-up PSG. Mandibular movement monitoring readily identifies respiratory effort (RE) during upper airway obstruction. We hypothesized that mandibular movements (MMas) indices for RE would decrease in a similar fashion as classical PSG indices, and that children with persistent RE could be reliably identified with MMas as with PSG.Methods 25 children (3-12 years of age) were diagnosed with SDB over a period of 3 months. PSG was supplemented with a midsagittal movement magnetic sensor that measured MMas during each respiratory cycle before and >3 months after AT. The effect of AT was evaluated by linear mixed-model with best-fit distribution.Results AT did significantly improve PSG indices, except RERA. MMas index changes under AT were significantly correlated with corresponding decreases in AHI, RDI and ODI (r=0.98, 0.98 and 0.92, respectively), while changes in MMas duration were significantly associated with both RERA duration (r=0.475, p=0.017) and RERA index (r=0.56, p=0.003). Conditional multivariate analysis showed that both AHI and RERA indices contributed significantly to the variance of MMas index after AT (p<0.001), while MMas duration was consistently related to the duration of RERA regardless of AT.Conclusion AT significantly reduced AHI. However, residual AHI and persistent RE were apparent in a significant proportion of children. Follow-up of children with persistent RE after AT can be readily achieved by monitoring MMas. Figure 1: Example of MMas