Long-Term Impact of Sleep-Disordered Breathing on Quality of Life in Children With Obesity

Abstract Introduction Adenotonsillectomy is the first-line treatment for obstructive sleep apnea secondary to adenotonsillar hypertrophy in children. The physical benefits of this surgery are well known as well as its impact on the quality of life (QoL), mainly according to short-term evaluations. However, the long-term effects of this surgery are still unclear. Objective To evaluate the long-term impact of adenotonsillectomy on the QoL of children with sleep-disordered breathing (SDB). Method This was a prospective non-controlled study. Children between 3 and 13 years of age with symptoms of SDB for whom adenotonsillectomy had been indicated were included. Children with comorbities were excluded. Quality of life was evaluated using the obstructive sleep apnea questionnaire (OSA-18), which was completed prior to, 10 days, 6 months, 12 months and, at least, 18 months after the procedure. For statistical analysis, p-values lower than 0.05 were defined as statistically significant. Results A total of 31 patients were enrolled in the study. The average age was 5.2 years, and 16 patients were male. The OSA-18 scores improved after the procedure in all domains, and this result was maintained until the last evaluation, done 22 ± 3 months after the procedure. Improvement in each domain was not superior to achieved in other domains. No correlation was found between tonsil or adenoid size and OSA-18 scores. Conclusion This is the largest prospective study that evaluated the long-term effects of the surgery on the QoL of children with SDB using the OSA-18. Our results show adenotonsillectomy has a positive impact in children's QoL.

Download Full-text

Long-Term Impact of Adenotonsillectomy on Quality of Life in Thai Children with Sleep-Disordered Breathing

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.08.8515 ◽

2020 ◽

Vol 103 (8) ◽

pp. 736-740

Keyword(s):

Quality Of Life ◽

Sleep Disordered Breathing ◽

Pediatric Population ◽

Apnea Hypopnea Index ◽

Obstructive Sleep ◽

Siriraj Hospital ◽

Long Term Impact ◽

Disordered Breathing

Background: Sleep disordered breathing (SDB) is a spectrum of disorders that is characterized by abnormal respiratory patterns during sleep, with symptoms that include snoring, mouth breathing, and pauses in breathing. No previous study has investigated the long-term impact of adenotonsillectomy on the quality of life in Thai children with SDB. Objective: To investigate the long-term impact of adenotonsillectomy on the quality of life in Thai pediatric patients with SDB as measured by Obstructive Sleep Apnea-18 (OSA-18) questionnaire. Materials and Methods: The present study was retrospectively conducted in Thai pediatric SDB that underwent adenotonsillectomy at Siriraj Hospital between January 1997 and December 2010. Caregivers of the present study children completed the OSA-18 questionnaire pre-operatively and at least 6-months post-operatively. Demographic and pre-operative polysomnography (PSG) data were also collected and analyzed. Pre-operative and post-operative OSA-18 total score and OSA-18 scores for all five domains were compared using paired t-test. Results: Forty-nine children with SDB that underwent adenotonsillectomy were included. There were 30 boys (61.2%) and 19 girls (38.8%), with a mean age of 6.1±2.6 years (range 3.0 to 12.1). Pre-operative PSG was performed in 32 children (65.3%), with a mean apnea-hypopnea index of 12.6±12.4. Mean pre-operative and post-operative total OSA-18 score was 69.8±16.1 and 36.0±12.9, respectively. Mean duration from surgery to completion of the OSA-18 questionnaire after adenotonsillectomy was 12.5±4.6 months (range 6 to 28). Total OSA-18 score and the scores for all five OSA-18 domains were significantly improved after adenotonsillectomy (p<0.001 and <0.001, respectively). Conclusion: Long-term quality of life in Thai children with SDB was improved significantly after adenotonsillectomy, as evidenced by the significant improvement in OSA-18 total score and all OSA-18 domains. Based on these findings, the authors encourage adenotonsillectomy as the first-line treatment for SDB in Thai pediatric population. Keywords: Long-term impact, Adenotonsillectomy, Quality of life, Thai children, Sleep-disordered breathing, SDB

Download Full-text

Prophylactic Total Gastrectomy: a Prospective Cohort Study of Long-Term Impact on Quality of Life

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-016-3287-8 ◽

2016 ◽

Vol 20 (12) ◽

pp. 1950-1958 ◽

Cited By ~ 11

Author(s):

Jennifer Muir ◽

Melyssa Aronson ◽

Mary-Jane Esplen ◽

Aaron Pollett ◽

Carol J. Swallow

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Total Gastrectomy ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Long Term Impact ◽

Prophylactic Total Gastrectomy

Download Full-text

Impact of tonsillotomy versus tonsillectomy on health-related quality of life and healthcare costs in children with sleep-disordered breathing

The Journal of Laryngology & Otology ◽

10.1017/s0022215121003832 ◽

2021 ◽

pp. 1-22

Author(s):

Anniina J Sakki ◽

Risto P Roine ◽

Laura K Mäkinen ◽

Harri Sintonen ◽

Johanna Nokso-Koivisto

Keyword(s):

Quality Of Life ◽

Healthcare Costs ◽

Sleep Disordered Breathing ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Disordered Breathing

Download Full-text

Antibiotic treatment of exacerbations of COPD in general practice: long-term impact on healthrelated quality of life

International Journal of Chronic Obstructive Pulmonary Disease ◽

10.2147/copd.s8732 ◽

2010 ◽

pp. 11 ◽

Cited By ~ 3

Author(s):

Miravitlles

Keyword(s):

Quality Of Life ◽

General Practice ◽

Antibiotic Treatment ◽

Long Term Impact ◽

Healthrelated Quality Of Life

Download Full-text

Early postoperative complications have long-term impact on quality of life after restorative proctocolectomy

Medicine ◽

10.1097/md.0000000000003966 ◽

2016 ◽

Vol 95 (27) ◽

pp. e3966 ◽

Cited By ~ 9

Author(s):

Andrew McCombie ◽

Yun Lee ◽

Rutvik Vanamala ◽

Richard Gearry ◽

Frank Frizelle ◽

...

Keyword(s):

Quality Of Life ◽

Postoperative Complications ◽

Restorative Proctocolectomy ◽

Early Postoperative Complications ◽

Long Term Impact

Download Full-text

Quality of life of children with sleep-disordered breathing treated with adenotonsillectomy

The Journal of Laryngology & Otology ◽

10.1017/s0022215110001635 ◽

2010 ◽

Vol 125 (2) ◽

pp. 193-198 ◽

Cited By ~ 10

Author(s):

S M Powell ◽

M Tremlett ◽

D A Bosman

Keyword(s):

Quality Of Life ◽

Obstructive Sleep Apnoea ◽

Sleep Disordered Breathing ◽

Sleep Apnoea ◽

Life Assessment ◽

Effect Sizes ◽

Obstructive Sleep ◽

Disordered Breathing

AbstractObjective:To assess the quality of life of UK children with sleep-disordered breathing undergoing adenotonsillectomy, by using the Obstructive Sleep Apnoea 18 questionnaire and determining score changes and effect sizes.Design:Prospective, longitudinal study.Setting:The otolaryngology department of a university teaching hospital in Northern England.Participants:Twenty-eight children for whom adenotonsillectomy was planned as treatment for sleep-disordered breathing, and who had either a clinical history consistent with obstructive sleep apnoea or a polysomnographic diagnosis.Main outcome measure:The Obstructive Sleep Apnoea 18 questionnaire, a previously validated, disease-specific quality of life assessment tool; changes in questionnaire scores and effect sizes were assessed.Methods:The Obstructive Sleep Apnoea 18 questionnaire was administered to each child's parent pre-operatively, then again at the follow-up appointment. Questionnaire scores ranged from 1 to 7. Score changes were analysed using the paired t-test; effect sizes were calculated using 95 per cent confidence intervals.Results:Complete data were obtained for 22 children (mean age, 61 months). Ten had undergone pre-operative polysomnography. Twenty-one children underwent adenotonsillectomy (one underwent tonsillectomy). Median follow up was eight weeks (interquartile range, six to 11 weeks). Following surgery, the overall mean score improvement was 2.6 (p < 0.0001) and the mean effect size 2.4 (95 per cent confidence interval 1.9 to 2.8). There were significant improvements in each of the individual questionnaire domains, i.e. sleep disturbance (mean score change 3.9, p < 0.0001), physical suffering (2.2, p < 0.0001), emotional distress (2.0, p = 0.0001), daytime problems (1.8, p = 0.0001) and caregiver concerns (2.6, p < 0.0001).Conclusion:In these children with sleep-disordered breathing treated by adenotonsillectomy, Obstructive Sleep Apnoea 18 questionnaire results indicated significantly improved mean score changes and effect sizes across all questionnaire domains, comparing pre- and post-operative data.

Download Full-text