Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/103885
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Type: Journal article
Title: Adenotonsillectomy for childhood obstructive sleep apnoea reduces thoraco-abdominal asynchrony but spontaneous apnoea-hypopnoea index normalisation does not
Author: Liu, X.
Immanuel, S.
Pamula, Y.
Kennedy, D.
Martin, J.
Baumert, M.
Citation: European Respiratory Journal, 2017; 49(1):1601177-1-1601177-10
Publisher: European Respiratory Society
Issue Date: 2017
ISSN: 0903-1936
1399-3003
Statement of
Responsibility: 
Xiao Liu, Sarah Immanuel, Yvonne Pamula, Declan Kennedy, James Martin and Mathias Baumert
Abstract: The efficacy of adenotonsillectomy for treating obstructive sleep apnoea syndrome (OSAS) in children has been established, but its precise effects on inspiratory effort are not well documented.In 353 children enrolled in the Childhood Adenotonsillectomy Trial, randomised to undergo either early adenotonsillectomy (n=182) or a strategy of watchful waiting with supportive care (WWSC) (n=171), thoraco-abdominal asynchrony (TAA) was analysed during quiet, non-apnoeic and non-hypopnoeic breathing during sleep at baseline and at 7 months using overnight polysomnography.Children who underwent early adenotonsillectomy demonstrated a reduction in TAA post-surgery while the WWSC arm showed no change. On assessing TAA with regard to normalisation of clinical polysomnography findings at follow-up, TAA was reduced in children who had surgical resolution of OSAS (based on apnoea-hypopnoea index), but not in children who displayed spontaneous normalisation of apnoea-hypopnoea index. In the latter group, TAA was inversely correlated with quality of life.We conclude that adenotonsillectomy reduces TAA during quiet sleep. Monitoring of instantaneous TAA may yield additional insight in the dynamic changes of inspiratory effort. In combination with traditional indices of obstruction, TAA may more accurately characterise the degree of sleep-disordered breathing in children.
Keywords: Humans; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Recurrence; Polysomnography; Treatment Outcome; Adenoidectomy; Tonsillectomy; Severity of Illness Index; Linear Models; Quality of Life; Child; United States; Female; Male; Neurophysiological Monitoring
Rights: Copyright ©ERS 2017
RMID: 0030057422
DOI: 10.1183/13993003.01177-2016
Grant ID: http://purl.org/au-research/grants/arc/DP110102049
Appears in Collections:Electrical and Electronic Engineering publications

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