Central and mixed apneas in children with obstructive sleep apnea: effect of adenotonsillectomy

Abstract

Purpose: Investigate the effect of adenotonsillectomy on mixed apnea index (MAI) and central apnea index (CAI) in children with moderate-to-severe obstructive sleep apnea syndrome (OSAS). Methods: Observational retrospective analysis of polysomnographic data in children diagnosed with moderate-to-severe OSAS and without comorbidity, submitted to adenotonsillectomy. Results: Data were available for 80 children, 55 boys and 25 girls, with a median age of 3.6 years (2.1–5.9). Before surgery AHI was 14.1 (11.0–18.4) per hour, with a median preoperative OAI of 7.1 (4.1–10.6), MAI of 1.2 (0.6–1.6) and CAI of 1.0 (0.4–2.0). Adenotonsillectomy caused significant improvements in MAI, from 1.2 (0.6–1.6) to 0.5 (0.1–0.8) (p < 0.001) and CAI from 1.0 (0.4–2.0) to 0.5 (0.1–0.9) (p < 0.001). This represents a normalization of MAI in 91.7% and CAI in 75.6% of children that had an abnormal value prior surgery. Conclusion: Non obstructive apneas are common in children with OSAS. Adenotonsillectomy caused significant decrease not only in OAI, but also in MAI and CAI in children with moderate-to-severe OSAS.