Cognitive effects of adenotonsillectomy for obstructive sleep apnea

H. Gerry Taylor, Susan R. Bowen, Dean W. Beebe, Elise Hodges, Raouf Amin, Raanan Arens, Ronald D. Chervin, Susan L. Garetz, Eliot S. Katz, Reneé H. Moore, Knashawn H. Morales, Hiren Muzumdar, Shalini Paruthi, Carol L. Rosen, Anjali Sadhwani, Nina Hattiangadi Thomas, Janice Ware, Carole L. Marcus, Susan S. Ellenberg, Susan RedlineBruno Giordani

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

OBJECTIVE: Research reveals mixed evidence for the effects of adenotonsillectomy (AT) on cognitive tests in children with obstructive sleep apnea syndrome (OSAS). The primary aim of the study was to investigate effects of AT on cognitive test scores in the randomized Childhood Adenotonsillectomy Trial. METHODS: Children ages 5 to 9 years with OSAS without prolonged oxyhemoglobin desaturation were randomly assigned to watchful waiting with supportive care (n = 227) or early AT (eAT, n = 226). Neuropsychological tests were administered before the intervention and 7 months after the intervention. Mixed model analysis compared the groups on changes in test scores across follow-up, and regression analysis examined associations of these changes in the eAT group with changes in sleep measures. RESULTS: Mean test scores were within the average range for both groups. Scores improved significantly (P < .05) more across follow-up for the eAT group than for the watchful waiting group. These differences were found only on measures of nonverbal reasoning, fine motor skills, and selective attention and had small effects sizes (Cohen's d, 0.20-0.24). As additional evidence for AT-related effects on scores, gains in test scores for the eAT group were associated with improvements in sleep measures. CONCLUSIONS: Small and selective effects of AT were observed on cognitive tests in children with OSAS without prolonged desaturation. Relative to evidence from Childhood Adenotonsillectomy Trial for larger effects of surgery on sleep, behavior, and quality of life, AT may have limited benefits in reversing any cognitive effects of OSAS, or these benefits may require more extended follow-up to become manifest.

Original languageEnglish (US)
Article numbere20154458
JournalPediatrics
Volume138
Issue number2
DOIs
StatePublished - Aug 1 2016

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Obstructive Sleep Apnea
Watchful Waiting
Sleep
Oxyhemoglobins
Motor Skills
Neuropsychological Tests
Regression Analysis
Quality of Life
Research
Test Scores
Syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)
  • Arts and Humanities (miscellaneous)

Cite this

Taylor, H. G., Bowen, S. R., Beebe, D. W., Hodges, E., Amin, R., Arens, R., ... Giordani, B. (2016). Cognitive effects of adenotonsillectomy for obstructive sleep apnea. Pediatrics, 138(2), [e20154458]. https://doi.org/10.1542/peds.2015-4458

Cognitive effects of adenotonsillectomy for obstructive sleep apnea. / Taylor, H. Gerry; Bowen, Susan R.; Beebe, Dean W.; Hodges, Elise; Amin, Raouf; Arens, Raanan; Chervin, Ronald D.; Garetz, Susan L.; Katz, Eliot S.; Moore, Reneé H.; Morales, Knashawn H.; Muzumdar, Hiren; Paruthi, Shalini; Rosen, Carol L.; Sadhwani, Anjali; Thomas, Nina Hattiangadi; Ware, Janice; Marcus, Carole L.; Ellenberg, Susan S.; Redline, Susan; Giordani, Bruno.

In: Pediatrics, Vol. 138, No. 2, e20154458, 01.08.2016.

Research output: Contribution to journalArticle

Taylor, HG, Bowen, SR, Beebe, DW, Hodges, E, Amin, R, Arens, R, Chervin, RD, Garetz, SL, Katz, ES, Moore, RH, Morales, KH, Muzumdar, H, Paruthi, S, Rosen, CL, Sadhwani, A, Thomas, NH, Ware, J, Marcus, CL, Ellenberg, SS, Redline, S & Giordani, B 2016, 'Cognitive effects of adenotonsillectomy for obstructive sleep apnea', Pediatrics, vol. 138, no. 2, e20154458. https://doi.org/10.1542/peds.2015-4458
Taylor HG, Bowen SR, Beebe DW, Hodges E, Amin R, Arens R et al. Cognitive effects of adenotonsillectomy for obstructive sleep apnea. Pediatrics. 2016 Aug 1;138(2). e20154458. https://doi.org/10.1542/peds.2015-4458
Taylor, H. Gerry ; Bowen, Susan R. ; Beebe, Dean W. ; Hodges, Elise ; Amin, Raouf ; Arens, Raanan ; Chervin, Ronald D. ; Garetz, Susan L. ; Katz, Eliot S. ; Moore, Reneé H. ; Morales, Knashawn H. ; Muzumdar, Hiren ; Paruthi, Shalini ; Rosen, Carol L. ; Sadhwani, Anjali ; Thomas, Nina Hattiangadi ; Ware, Janice ; Marcus, Carole L. ; Ellenberg, Susan S. ; Redline, Susan ; Giordani, Bruno. / Cognitive effects of adenotonsillectomy for obstructive sleep apnea. In: Pediatrics. 2016 ; Vol. 138, No. 2.
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abstract = "OBJECTIVE: Research reveals mixed evidence for the effects of adenotonsillectomy (AT) on cognitive tests in children with obstructive sleep apnea syndrome (OSAS). The primary aim of the study was to investigate effects of AT on cognitive test scores in the randomized Childhood Adenotonsillectomy Trial. METHODS: Children ages 5 to 9 years with OSAS without prolonged oxyhemoglobin desaturation were randomly assigned to watchful waiting with supportive care (n = 227) or early AT (eAT, n = 226). Neuropsychological tests were administered before the intervention and 7 months after the intervention. Mixed model analysis compared the groups on changes in test scores across follow-up, and regression analysis examined associations of these changes in the eAT group with changes in sleep measures. RESULTS: Mean test scores were within the average range for both groups. Scores improved significantly (P < .05) more across follow-up for the eAT group than for the watchful waiting group. These differences were found only on measures of nonverbal reasoning, fine motor skills, and selective attention and had small effects sizes (Cohen's d, 0.20-0.24). As additional evidence for AT-related effects on scores, gains in test scores for the eAT group were associated with improvements in sleep measures. CONCLUSIONS: Small and selective effects of AT were observed on cognitive tests in children with OSAS without prolonged desaturation. Relative to evidence from Childhood Adenotonsillectomy Trial for larger effects of surgery on sleep, behavior, and quality of life, AT may have limited benefits in reversing any cognitive effects of OSAS, or these benefits may require more extended follow-up to become manifest.",
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AU - Arens, Raanan

AU - Chervin, Ronald D.

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AU - Thomas, Nina Hattiangadi

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AU - Redline, Susan

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