OBJECTIVE: Obstructive sleep apnea, a common indication for adenotonsillectomy in children, has been linked to behavioral morbidity. We assessed psychiatric diagnoses in children before and after adenotonsillectomy and examined whether baseline sleep apnea predicted improvement after surgery. METHOD: Subjects of this prospective cohort study were children ages 5.0 to 12.9 years old who had been scheduled for adenotonsillectomy (n = 79) or care for unrelated surgical conditions (n = 27, among whom 13 had surgery after baseline assessment). Before intervention and 1 year later, subjects underwent structured diagnostic interviews and polysomnography. The main outcome measure was frequency of DSM-IV attention and disruptive behavior disorder diagnoses at baseline and follow-up. RESULTS: At baseline, attention and disruptive behavior disorders were diagnosed in 36.7% of adenotonsillectomy subjects and 11.1% of controls (p < .05); attention-deficit/hyperactivity disorder was found in 27.8% and 7.4%, respectively (p < .05). One year later, group differences were nonsignificant; attention and disruptive behavior disorders were diagnosed in only 23.1% (p < .01), and 50% of subjects with baseline attention-deficit/hyperactivity disorder no longer met diagnostic criteria. Obstructive sleep apnea on polysomnography at baseline did not predict concurrent psychiatric morbidity or later improvement. CONCLUSIONS: Attention and disruptive behavior disorders, diagnosed by DSM-IV criteria, were more common before clinically indicated adenotonsillectomy than 1 year later. Surgery may be associated with reduced morbidity, even among subjects lacking polysomnographic evidence of obstructive sleep apnea.
OBJECTIVE:Obstructive sleep apnea, a common indication for adenotonsillectomy in children, has been linked to behavioral morbidity. We assessed psychiatric diagnoses in children before and after adenotonsillectomy and examined whether baseline sleep apnea predicted improvement after surgery. METHOD: Subjects of this prospective cohort study were children ages 5.0 to 12.9 years old who had been scheduled for adenotonsillectomy (n = 79) or care for unrelated surgical conditions (n = 27, among whom 13 had surgery after baseline assessment). Before intervention and 1 year later, subjects underwent structured diagnostic interviews and polysomnography. The main outcome measure was frequency of DSM-IV attention and disruptive behavior disorder diagnoses at baseline and follow-up. RESULTS: At baseline, attention and disruptive behavior disorders were diagnosed in 36.7% of adenotonsillectomy subjects and 11.1% of controls (p < .05); attention-deficit/hyperactivity disorder was found in 27.8% and 7.4%, respectively (p < .05). One year later, group differences were nonsignificant; attention and disruptive behavior disorders were diagnosed in only 23.1% (p < .01), and 50% of subjects with baseline attention-deficit/hyperactivity disorder no longer met diagnostic criteria. Obstructive sleep apnea on polysomnography at baseline did not predict concurrent psychiatric morbidity or later improvement. CONCLUSIONS: Attention and disruptive behavior disorders, diagnosed by DSM-IV criteria, were more common before clinically indicated adenotonsillectomy than 1 year later. Surgery may be associated with reduced morbidity, even among subjects lacking polysomnographic evidence of obstructive sleep apnea.
Authors: Daniel J Gottlieb; Cynthia Chase; Richard M Vezina; Timothy C Heeren; Michael J Corwin; Sanford H Auerbach; Debra E Weese-Mayer; Samuel M Lesko Journal: J Pediatr Date: 2004-10 Impact factor: 4.406
Authors: Nira A Goldstein; Vasanthi Pugazhendhi; Sudha M Rao; Jeremy Weedon; Thomas F Campbell; Andrew C Goldman; J Christopher Post; Madu Rao Journal: Pediatrics Date: 2004-07 Impact factor: 7.124
Authors: D R Offord; M H Boyle; P Szatmari; N I Rae-Grant; P S Links; D T Cadman; J A Byles; J W Crawford; H M Blum; C Byrne Journal: Arch Gen Psychiatry Date: 1987-09
Authors: Susan Redline; Raouf Amin; Dean Beebe; Ronald D Chervin; Susan L Garetz; Bruno Giordani; Carole L Marcus; Renee H Moore; Carol L Rosen; Raanan Arens; David Gozal; Eliot S Katz; Ronald B Mitchell; Hiren Muzumdar; H G Taylor; Nina Thomas; Susan Ellenberg Journal: Sleep Date: 2011-11-01 Impact factor: 5.849
Authors: Elise Hodges; Carole L Marcus; Ji Young Kim; Melissa Xanthopoulos; Justine Shults; Bruno Giordani; Dean W Beebe; Carol L Rosen; Ronald D Chervin; Ron B Mitchell; Eliot S Katz; David Gozal; Susan Redline; Lisa Elden; Raanan Arens; Renee Moore; H Gerry Taylor; Jerilynn Radcliffe; Nina H Thomas Journal: Sleep Date: 2018-12-01 Impact factor: 5.849
Authors: Louise M O'Brien; Neali H Lucas; Barbara T Felt; Timothy F Hoban; Deborah L Ruzicka; Ruth Jordan; Kenneth Guire; Ronald D Chervin Journal: Sleep Med Date: 2011-05-26 Impact factor: 3.492
Authors: Michelle M Perfect; Kristen Archbold; James L Goodwin; Deborah Levine-Donnerstein; Stuart F Quan Journal: Sleep Date: 2013-04-01 Impact factor: 5.849
Authors: Merrill S Wise; Cynthia D Nichols; Madeleine M Grigg-Damberger; Carole L Marcus; Manisha B Witmans; Valerie G Kirk; Lynn A D'Andrea; Timothy F Hoban Journal: Sleep Date: 2011-03-01 Impact factor: 5.849
Authors: Teresa M Ward; Sarah Ringold; Jonika Metz; Kristen Archbold; Martha Lentz; Carol A Wallace; Carol A Landis Journal: Arthritis Care Res (Hoboken) Date: 2011-07 Impact factor: 4.794
Authors: Sarah N Biggs; Anna Vlahandonis; Vicki Anderson; Robert Bourke; Gillian M Nixon; Margot J Davey; Rosemary S C Horne Journal: Sleep Date: 2014-01-01 Impact factor: 5.849