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CC BY-NC-ND 4.0 · Sleep Sci 2021; 14(04): 330-336
DOI: 10.5935/1984-0063.20200093
ORIGINAL ARTICLE

Quality of life related to residual snoring after adenotonsillectomy: a pilot study

Authors

  • Rita Catia Brás Bariani

    1   Universidade Federal de São Paulo, Department of Otorhinolaryngology and Head and Neck Surgery - São Paulo - SP - Brazil.

  • Thais Moura Guimaraes

    2   Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - SP - Brazil.

  • Wilana Moura

    3   Faculdade de Odontologia de Bauru, Departamento de Ortodontia - São Paulo - SP - Brazil.

  • Mario Cappellette Junior

    1   Universidade Federal de São Paulo, Department of Otorhinolaryngology and Head and Neck Surgery - São Paulo - SP - Brazil.

  • Sergio Tufik

    2   Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - SP - Brazil.

  • Gustavo A. Moreira

    2   Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - SP - Brazil.

  • Reginaldo Raimundo Fujita

    1   Universidade Federal de São Paulo, Department of Otorhinolaryngology and Head and Neck Surgery - São Paulo - SP - Brazil.
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Introduction Few studies have addressed long-term quality of life related to residual snoring after adenotonsillectomy. The aim of this study was to compare scores from the OSA-18 questionnaire between children with residual snoring and non-snoring children two or more years after adenotonsillectomy.

Material and Methods The sample comprised 25 children divided into two groups, a group of 14 snoring children, and a control group of 11 non-snoring children. The OSA-18 questionnaire was applied to the volunteers. In the control group, it was completed by the caregivers of the children, while in individuals with residual snoring it was completed by the caregivers of children in the presence of a doctor or dentist. A statistical comparison was made using a generalized linear model.

Results The snorer group had a higher total OSA-18 score, and a higher score in all five domains compared to the control group.

Conclusion Children with residual snoring two or more years after adenotonsillectomy may have a worse quality of life compared to the control group.

Sleep Apnea - Obstructive - Snoring - Indicators of Quality of Life - Tonsillectomy

APPENDIX



Publication History

Received: 02 September 2020

Accepted: 01 February 2021

Article published online:
30 November 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • REFERENCES

  • 1 Schechter MS. Technical report: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2002 Apr;109(4):e69.
  • 2 Izu SC, Itamoto CH, Pradella-Hallinan M, Pizarro GU, Tufik S, Pignatari S, et al. Obstructive sleep apnea syndrome (OSAS) in mouth breathing children. Braz J Otorhinolaryngol. 2010 Oct;76(5):552-6. DOI: https://doi.org/10.1590/S1808-86942010000500003
  • 3 Petry C, Pereira MU, Pitrez PM, Jones MH, Stein RT. The prevalence of symptoms of sleep- disordered breathing in Brazilian schoolchildren. J Pediatr (Rio J). 2008 Apr;84(2):123-9. DOI: https://doi.org/10.1590/ S0021-75572008000200006
  • 4 Chervin RD, Ruzicka DL, Hoban TF, Fetterolf JL, Garetz SL, Guire KE, et al. Esophageal pressures, polysomnography, and neurobehavioral outcomes of adenotonsillectomy in children. Chest. 2012 Jul;142(1):101-10. DOI: https://doi.org/10.1378/chest.11-2456
  • 5 Guilleminault C, Huang YS, Glamann C, Li K, Chan A. Adenotonsillectomy and obstructive sleep apnea in children: a prospective survey. Otolaryngol Head Neck Surg. 2007 Feb;136(2):169-75. DOI: https://doi.org/10.1016/j.otohns.2006.09.021
  • 6 Tauman R, Gulliver TE, Krishna J, Montgomery-Downs HE, O’Brien LM, Ivanenko A, et al. Persistence of obstructive sleep apnea syndrome in children after adenotonsillectomy. J Pediatr. 2006 Dec;149(6):803-8. DOI: https://doi.org/10.1016/j.jpeds.2006.08.067
  • 7 Sistla SK, Lahane V. OSA 18 questionnaire: tool to evaluate quality of life and efficacy of treatment modalities in pediatric sleep disordered breathing due to adenotonsillar hypertrophy. Indian J Otolaryngol Head Neck Surg. 2019 Nov;71. DOI: https://doi.org/10.1007/s12070-019-01757-0
  • 8 Lagravere MO, Major PW, Flores-Mir C. Long-term dental arch changes after rapid maxillary expansion treatment: a systematic review. Angle Orthod. 2005 Mar;75(2):155- 61.
  • 9 Wu LM, Wu XF, Yu ZM, Liu Y. Systematic review on orofacial myofunctional therapy to treat obstructive sleep apnea-hypopnea syndrome. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Nov;31(22):1774-7.
  • 10 Friedman M, Wilson M, Lin HC, Chang HW. Updated systematic review of tonsillectomy and adenoidectomy for treatment of pediatric obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg. 2009 Jun;140(6):800-8. DOI: https://doi.org/10.1016/j.otohns.2009.01.043
  • 11 Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012 Sep;130(3):e714-55. DOI: https://doi. org/10.1542/peds.2012-1672
  • 12 Huynh NT, Desplats E, Almeida FR. Orthodontics treatments for managing obstructive sleep apnea syndrome in children: a systematic review and meta-analysis. Sleep Med Rev. 2016 Feb;25:84-94. DOI: https://doi.org/10.1016/j.smrv.2015.02.002
  • 13 Nishikawa H, Pearman K, Dover S. Multidisciplinary management of children with craniofacial syndromes with particular reference to the airway. Int J Pediatr Otorhinolaryngol. 2003 Dec;67(Suppl 1):S91-3. DOI: https://doi.org/10.1016/j.ijporl.2003.08.037
  • 14 Serres LM, Derkay C, Astley S, Deyo RA, Rosenfeld RM, Gates GA. Measuring quality of life in children with obstructive sleep disorders. Arch Otolaryngol Head Neck Surg, 2000;126(12):1423-9. DOI: https://doi.org/10.1001/archotol.126.12.1423
  • 15 Serres LM, Derkay C, Sie K, Biavati M, Jones J, Tunkel D, et al. Impact of adenotonsillectomy on quality of life in children with obstructive sleep disorders. Arch Otolaryngol Head Neck Surg. 2002;128(5):489-96. DOI: https://doi.org/10.1001/archotol.128.5.489
  • 16 Nascimento GMS, Salgado DC, Maia MS, Lambert EE, Pio MRB, Tiago RSL. Impacto do tratamento cirúrgico na qualidade de vida de crianças com hiperplasia de tonsilas. Acta ORL. 2007;25:119-23.
  • 17 Van Staaji BK, Van Den Akker EH, Rovers MM, Hordijk GJ, Hoes AW, Schilder AG. Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial. Clin Otolaryngol. 2005 Mar;30(1):60-3. DOI: https://doi.org/10.1111/j.1365-2273.2005.00980.x
  • 18 Lima Júnior JM, Silva VC, Freitas MR. Long term results in the life quality of children with obstructive sleep disorders submitted to adenoidectomy/ adenotonsillectomy. Braz J Otorhinolaryngol. 2008 Oct;74(5):718-24. DOI: https://doi.org/10.1590/S0034-72992008000500013
  • 19 Song IS, Hong SN, Joo JW, Han MS, Hwang SJ, Seo MY, et al. Longterm results of sleep-related quality-of-life and behavioral problems after adenotonsillectomy. Laryngoscope. 2020 Feb;130(2):546-50. DOI: https://doi.org/10.1002/lary.27951
  • 20 Lee CH, Kang KT, Weng WC, Lee PL, Hsu WC. Quality of life after adenotonsillectomy in children with obstructive sleep apnea: shortterm and long-term results. Int J Pediatr
  • 21 Otorhinolaryngol. 2015 Feb;79(2):210-5. DOI: https://doi. org/10.1016/j.ijporl.2014.12.011
  • 22 Imanguli M, Ulualp SO. Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children. Laryngoscope. 2016;126(11):2624-9. DOI: https://doi.org/10.1002/lary.25979
  • 23 Pomerantz J. Management of persistent obstructive sleep apnea after adenotonsillectomy. Pediatr Ann. 2016;45(5):e180-3. DOI: https://doi. org/10.3928/00904481-20160329-01
  • 24 Tauman R, Gulliver TE, Krishna J, Montgomery-Downs HE, O’Brien LM, Ivanenko A, et al. Persistence of obstructive sleep apnea syndrome in children after adenotonsillectomy. 2006 Dec;149(6):803-8. DOI: https://doi.org/10.1016/j.jpeds.2006.08.067
  • 25 Silva VC, Leite AJM. Quality of life in children with sleep-disordered breathing: evaluation by OSA-18. Braz J Otorhinolaryngol. 2006 Dec;72(6):747-56. DOI: https://doi.org/10.1590/S0034-72992006000600005
  • 26 Ali N, Pitson D, Stradling J. Snoring, sleep disturbance, and behaviour in 4-5 year olds. Arch Dis Child. 1993;68(3):360-6. DOI: https://doi. org/10.1136/adc.68.3.360
  • 27 Nieminen P, Tolonen U, Löppönen H. Snoring and obstructive sleep apnea in children: a 6month follow-up study. Arch Otoloryngol Head Neck Surg. 2000;126(4):481-6.
  • 28 Bruni O. The importance of sleep for children’s well being. Sleep Med. 2010 Aug;11(7):599-600. DOI: https://doi.org/10.1016/j.sleep.2010.04.002
  • 29 O’Brien LM, Mervis CB, Holbrook CR, Bruner JL, Klaus CJ, Rutherford J, et al. Neurobehavioral implications of habitual snoring in children. Pediatrics. 2004 Jul;114(1):44-9. DOI: https://doi.org/10.1542/peds.114.1.44
  • 30 American Academy of Sleep Medicine (AASM). International classification of sleep disorders. 3rd ed. Darien, IL: AASM; 2014.
  • 31 Gozal D, Pope Junior DW. Snoring during early childhood and academic performance at ages thirteen to fourteen years. Pediatrics. 2001 May;107(6):1394-9. DOI: https://doi.org/10.1542/peds.107.6.1394
  • 32 O’Brien LM, Holbrook CR, Mervis CB, Klaus CJ, Bruner JL, Raffield TJ, et al. Sleep and neurobehavioral characteristics of 5- to 7-yearold children with parentally reported symptoms of attention-deficit/ hyperactivity disorder. Pediatrics. 2003 Mar;111(3):554-63. DOI: https://doi.org/10.1542/peds.111.3.554
  • 33 Tsara V, Amfilochiou A, Papagrigorakis JM, Georgopoulos D, Liolios E, Kadiths A, et al. Guidelines for diagnosing and treating sleep related breathing disorders in adults and children (Part 3: obstructive sleep apnea in children, diagnosis and treatment). Hippokratia. 2010 Jan;14(1):57-62.
  • 34 Uema SFH, Pignatari SSN, Fujita RR, Moreira GA, Pradella-Hallinan M, Weckx L. Assessment of cognitive learning function in children with obstructive sleep breathing disorders. Braz J Otorhinolaryngol. 2007 May/Jun;73(3):315-20. DOI: https://doi.org/10.1016/s1808-8694(15)30074-4
  • 35 Fernandes FMVS, Teles RCVV. Questionário da síndrome da apneia obstrutiva na criança- 18: versão portuguesa. Braz J Otorhinolaryngol. 2013 Nov/Dec;79(6):720-6. DOI: http://dx.doi.org/10.5935/1808-8694.20130132
  • 36 Franco Junior RA, Rosenfeld RM, Rao M. First place--resident clinical science award 1999. Quality of life for children with obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000 Jul;123(1):9-16. DOI: https://doi.org/10.1067/mhn.2000.105254
  • 37 Baldassari CM, Mitchell RB, Schubert C, Rudnick EF. Pediatric obstructive sleep apnea and quality of life: a meta-analysis. Otolaryngol Head Neck Surg. 2008 Mar;138(3):265-73. DOI: https://doi. org/10.1016/j.otohns.2007.11.003
  • 38 Marcus CL, Moore RH, Rosen CL, Giordani B, Garetz SL, Taylor G, et al. A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med. 2013 Jun;368(25):2366-76. DOI: https://doi. org/10.1056/NEJMoa1215881
  • 39 Mitchell RB, Kelly J, Call E, Yao N. Long-term changes in quality of life after surgery for pediatric obstructive sleep apnea. Arch Otolaryngol Head Neck Surg. 2004 Apr;130(4):409-12. DOI: https:// doi.org/10.1001/archotol.130.4.409
  • 40 Crabtree VM, Varni JW, Gozal D. Health-related quality of life and depressive symptoms in children with suspected sleep-disordered breathing. Sleep. 2004 Sep;27(6):1131-8. DOI: https://doi. org/10.1093/sleep/27.6.1131
  • 41 Goldstein NA, Fatima M, Campbell TF, Rosenfeld RM. Child behavior and quality of life before and after tonsillectomy and adenoidectomy. Arch Otolaryngol Head Neck Surg. 2002 Jul;128(7):770-5. DOI: https://doi.org/10.1001/archotol.128.7.770
  • 42 Montgomery-Downs HE, Crabtree VM, Gozal D. Cognition, sleep and respiration in at-risk children treated for obstructive sleep apnoea. Eur Respir J. 2005;25(2):336-42. DOI: https://doi.org/10.1183/09031936.05.00082904
  • 43 Blunden S, Lushington K, Kennedy D, Martin J, Dawson D. Behavior and neurocognitive performance in children aged 5-10 years who snore compared to controls. J Clin Exp Neuropsychol. 2000;22(5):554-68. DOI: https://doi.org/10.1076/1380-3395(200010)22:5;1-9;FT554
  • 44 Honaker SM, Street A, Daftary AS, Downs SM. The use of computer decision support for pediatric obstructive sleep apnea detection in primary care. J Clin Sleep Med. 2019 Mar;15(3):453-62. DOI: https:// doi.org/10.5664/jcsm.7674
  • 45 Todd CA, Bareiss AK, McCoul ED, Rodriguez KH. Adenotonsillectomy for obstructive sleep apnea and quality of life: systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2017 Nov;157(5):767-73. DOI: https://doi.org/10.1177/0194599817717480
  • 46 Guilleminault C, Akhtar F. Pediatric sleep-disordered breathing: new evidence on its development. Sleep Med Rev. 2015 Dec;24:46-56. DOI: https://doi.org/10.1016/j.smrv.2014.11.008