May 22, 2013
Surgery Results In Some Benefits For Children With Sleep Apnea
redOrbit Staff & Wire Reports - Your Universe Online
Removing the adenoids and tonsils with obstructive sleep apnea lead to measurable improvements in behavior, quality of life, and some symptoms, though no noticeable improvements in attention or executive functioning were detected, according to the results of a new randomized clinical trial.The findings of the Childhood Adenotonsillectomy Trial (CHAT), which were presented Tuesday at the American Thoracic Society International Conference in Philadelphia and have been published online by the New England Journal of Medicine, found that after seven months, the surgery improved many aspects of the patients´ day-to-day lives.
It is the first controlled test to compare the procedure with the so-called watchful waiting as a strategy for overcoming childhood obstructive sleep apnea syndrome — a condition in which structures in the back of the mouth can temporarily block breathing passages during slumber, said Gene Emery of Reuters.
CHAT, which was designed by the University of Michigan Health System, involved 464 children between the ages of five and nine and took place at seven different sleep centers throughout the US.
Each youngster was randomly placed in two groups — one of which received adenoid and tonsil surgery within a month after enrollment, and the other which received supportive medical care and careful monitoring, also known as watchful waiting. Their cognition, behavior, and quality of life were evaluated by psychometricians prior to the start of the study, and again seven months after CHAT´s conclusion.
The researchers reported finding no difference in the cognitive abilities of the two groups. However, those who underwent surgery demonstrated improved sleep quality and behavioral regulation, as well as improved quality of life characteristics such as increased activity levels and less daytime sleepiness.
Those benefits were even observed in overweight kids, despite existing uncertainty about the role of surgery for the condition. Furthermore, 79 percent of the children had resolution of their sleep apnea after seven months, compared to just 46 percent in the watchful waiting group, the study authors explained.
“A number of researchers have shown that in children, disruptive daytime behavior is linked to abnormal breathing during sleep, or the overall quality and quantity of sleep,” Dr. Ronald Chervin, a member of the CHAT Steering Committee and a co-author on the new paper, said in a statement. “The role of the tonsils and adenoids in interfering with breathing during a child's sleep, and the impact of removing them, becomes much clearer with these results.”
“Sleep medicine is a very new field, with many unanswered questions,” added Dr. Carole L. Marcus, director of at The Children's Hospital of Philadelphia Sleep Center and first author on the study. “For instance, we go to sleep each night, yet we don't even know truly understand the true purpose of sleep. But this study is a great first step in finding some of the answers.”