Polysomnographic Thresholds of Limited Use in Pediatric OSA
Polysomnographic resolution accounted for small proportion of change in symptoms, quality of life
MONDAY, Sept. 23, 2019 (HealthDay News) -- Polysomnographic resolution of obstructive sleep apnea (OSA) and changes in polysomnographic severity of OSA in children account for a small but significant proportion of changes in symptoms and disease-specific quality of life, according to a study published online Sept. 18 in Pediatrics.
Amal Isaiah, M.D., Ph.D., from the University of Maryland in Baltimore, and colleagues obtained polysomnographic, cognitive, behavioral, quality-of-life, and health outcomes at baseline and seven months from the Childhood Adenotonsillectomy Trial, which compared outcomes of early adenotonsillectomy to watchful waiting in 398 children with OSA aged 5 to 9 years. Causal mediation analysis was used to measure the changes in 18 outcomes.
The researchers found that 61 percent of the children experienced resolution of OSA at follow-up. A small but significant proportion of changes in symptoms (proportion mediated, 0.13) and disease-specific quality of life (proportion mediated, 0.11) was accounted for by polysomnographic resolution. Symptom score (proportion mediated, 0.18) and disease-specific quality-of-life outcomes (proportion mediated, 0.20) were similarly mediated by changes in polysomnographic severity. For the other 16 outcomes, there were no significant mediation effects. Between the trial arms, no significant interactions were observed.
"Resolution of an airway obstruction measured by a sleep study performed after an adenotonsillectomy has long been thought to correlate with improvement in sleep apnea symptoms, but we found this may not be the case," Isaiah said in a statement.
One author disclosed receipt of patient-related royalties for interventions related to sleep apnea and is an inventor of three technologies related to diagnosis and treatment of sleep apnea in adults.