Quality of life after adenotonsillectomy for obstructive sleep apnea in children

Objective: To study changes in quality of life in children after adenotonsillectomy for obstructive sleep apnea (OSA) documented by full-night polysomnography. Design and Setting: Prospective study of children with OSA at the University of New Mexico Children's Hospital, Albuquerque. Methods: Caregivers for children were asked to complete the OSA-18 quality of life survey prior to polysomnography. Children who met inclusion criteria and had a respiratory distress index higher than 1 were enrolled in the study and underwent adenotonsillectomy. Caregivers completed a second OSA-18 survey within 6 months of surgery. Scores from the preoperative and postoperative surveys were compared using the paired t test. Results: The study population included 60 children (mean age, 7.1 [range, 3-12] years), of whom 43 (72%) were male and 30 (50%) were younger than 6 years. Forty-seven children (78%) had a respiratory distress index of 10 or higher. The mean interval between the 2 surveys was 126 days. The mean total OSA-18 score was 71.4 before surgery and 35.8 after surgery. The domain with the greatest change in mean score was sleep disturbance, which improved by 11.5. The changes in total score, in the scores for each domain, and for each item of the OSA-18 survey were highly significant (P<.002). Conclusions: Children without significant comorbidities show a marked improvement in the domains of sleep disturbance, physical symptoms, emotional symptoms, and daytime functioning as reported by their caregivers after adeno tonsillectomy for OSA.