Elise Hodges1, Carole L Marcus2,3, Ji Young Kim3, Melissa Xanthopoulos4, Justine Shults5, Bruno Giordani1, Dean W Beebe6, Carol L Rosen7, Ronald D Chervin8, Ron B Mitchell9, Eliot S Katz10, David Gozal11, Susan Redline12,13,14, Lisa Elden15, Raanan Arens16, Renee Moore17, H Gerry Taylor18,19, Jerilynn Radcliffe2,5, Nina H Thomas4,5. 1. Department of Psychiatry, University of Michigan, Ann Arbor, MI. 2. Department of Pediatrics, University of Pennsylvania, Philadelphia, PA. 3. Sleep Center and Center for Human Phenomic Science, The Children's Hospital of Philadelphia, Philadelphia, PA. 4. Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA. 5. Center for Human Phenomic Science, The Children's Hospital of Philadelphia, Philadelphia, PA. 6. Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 7. Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH. 8. Department of Neurology and Sleep Disorders Center, University of Michigan, Ann Arbor, MI. 9. Department of Otolaryngology Head and Neck Surgery, University of Texas Southwestern and Children's Medical Center Dallas, Dallas, TX. 10. Division of Respiratory Diseases, Boston Children's Hospital, Boston, MA. 11. Department of Pediatrics, University of Chicago, Chicago, IL. 12. Department of Medicine, Brigham and Women's Hospital, Boston, MA. 13. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA. 14. Department of Medicine, Harvard Medical School, Boston, MA. 15. Division of Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, PA. 16. Division of Respiratory and Sleep Medicine, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, New York City, NY. 17. Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA. 18. Center for Behavioral Health, Nationwide Children's Hospital Research Institute, Columbus, OH. 19. Department of Pediatrics, Ohio State University, Columbus, OH.
Abstract
Study Objectives: Depressive symptoms following adenotonsillectomy (AT) relative to controls were examined in children with obstructive sleep apnea syndrome (OSAS). Methods: The Childhood Adenotonsillectomy Trial (CHAT) multisite study examined the impact of AT in 453 children aged 5 to 9.9 years with polysomnographic evidence of OSAS without prolonged desaturation, randomized to earlyadenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC). One hundred seventy-six children (eAT n = 83; WWSC n = 93) with complete evaluations for depressive symptomatology between baseline and after a 7-month intervention period were included in this secondary analysis. Results: Exact binomial test assessed proportion of depressive symptomatology relative to norms, while effects of AT and OSAS resolution were assessed through linear quantile mixed-models. Treatment group assignment did not significantly impact depression symptoms, although self-reported depression symptoms improved over time (p < 0.001). Resolution of OSAS symptoms demonstrated a small interaction effect in an unexpected direction, with more improvement in parent ratings of anxious/depressed symptoms for children without resolution (p = 0.030). Black children reported more severe depressive symptoms (p = 0.026) and parents of overweight/obese children reported more withdrawn/depressed symptoms (p = 0.004). Desaturation nadir during sleep was associated with self-report depressed (r = -0.17, p = 0.028), parent-reported anxious/depressed (r = -0.15, p = 0.049), and withdrawn/depressed (r = -0.24, p = 0.002) symptoms. Conclusions: Increased risk for depressed and withdrawn/depressed symptoms was detected among children with OSAS, and different demographic variables contributed to risk in self-reported and parent-reported depression symptoms. Arterial oxygen desaturation nadir during sleep was strongly associated with depressed symptoms. However, despite improvements in child-reported depressed symptoms over time, changes were unrelated to either treatment group or OSAS resolution status. Trials Registration: Childhood Adenotonsillectomy Study for Children with OSAS (CHAT), https://clinicaltrials.gov/show/NCT00560859, NCT00560859.
RCT Entities:
Study Objectives:Depressive symptoms following adenotonsillectomy (AT) relative to controls were examined in children with obstructive sleep apnea syndrome (OSAS). Methods: The Childhood Adenotonsillectomy Trial (CHAT) multisite study examined the impact of AT in 453 children aged 5 to 9.9 years with polysomnographic evidence of OSAS without prolonged desaturation, randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC). One hundred seventy-six children (eAT n = 83; WWSC n = 93) with complete evaluations for depressive symptomatology between baseline and after a 7-month intervention period were included in this secondary analysis. Results: Exact binomial test assessed proportion of depressive symptomatology relative to norms, while effects of AT and OSAS resolution were assessed through linear quantile mixed-models. Treatment group assignment did not significantly impact depression symptoms, although self-reported depression symptoms improved over time (p < 0.001). Resolution of OSAS symptoms demonstrated a small interaction effect in an unexpected direction, with more improvement in parent ratings of anxious/depressed symptoms for children without resolution (p = 0.030). Black children reported more severe depressive symptoms (p = 0.026) and parents of overweight/obesechildren reported more withdrawn/depressed symptoms (p = 0.004). Desaturation nadir during sleep was associated with self-report depressed (r = -0.17, p = 0.028), parent-reported anxious/depressed (r = -0.15, p = 0.049), and withdrawn/depressed (r = -0.24, p = 0.002) symptoms. Conclusions: Increased risk for depressed and withdrawn/depressed symptoms was detected among children with OSAS, and different demographic variables contributed to risk in self-reported and parent-reported depression symptoms. Arterial oxygen desaturation nadir during sleep was strongly associated with depressed symptoms. However, despite improvements in child-reported depressed symptoms over time, changes were unrelated to either treatment group or OSAS resolution status. Trials Registration: Childhood Adenotonsillectomy Study for Children with OSAS (CHAT), https://clinicaltrials.gov/show/NCT00560859, NCT00560859.
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: Nina Hattiangadi Thomas; Melissa S Xanthopoulos; Ji Young Kim; Justine Shults; Emma Escobar; Bruno Giordani; Elise Hodges; Ronald D Chervin; Shalini Paruthi; Carol L Rosen; Gerry H Taylor; Raanan Arens; Eliot S Katz; Dean W Beebe; Susan Redline; Jerilynn Radcliffe; Carole L Marcus Journal: Sleep Date: 2017-04-01 Impact factor: 5.849
Authors: 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 Redline; Bruno Giordani Journal: Pediatrics Date: 2016-08 Impact factor: 7.124
Authors: Carole L Marcus; Reneé H Moore; Carol L Rosen; Bruno Giordani; Susan L Garetz; H Gerry Taylor; Ron B Mitchell; Raouf Amin; Eliot S Katz; Raanan Arens; Shalini Paruthi; Hiren Muzumdar; David Gozal; Nina Hattiangadi Thomas; Janice Ware; Dean Beebe; Karen Snyder; Lisa Elden; Robert C Sprecher; Paul Willging; Dwight Jones; John P Bent; Timothy Hoban; Ronald D Chervin; Susan S Ellenberg; Susan Redline Journal: N Engl J Med Date: 2013-05-21 Impact factor: 91.245
Authors: James E Dillon; Sarah Blunden; Deborah L Ruzicka; Kenneth E Guire; Donna Champine; Robert A Weatherly; Elise K Hodges; Bruno J Giordani; Ronald D Chervin Journal: J Am Acad Child Adolesc Psychiatry Date: 2007-11 Impact factor: 8.829
Authors: Jun Duan; Wanyuan Xia; Kai Yang; Xuelei Li; Feng Zhang; Jie Xu; Ying Jiang; Jia Liang; Bing Li Journal: Biomed Res Int Date: 2022-07-11 Impact factor: 3.246
Authors: Gabriele Di Carlo; Francesca Zara; Milena Rocchetti; Angelica Venturini; Antonio José Ortiz-Ruiz; Valeria Luzzi; Paolo Maria Cattaneo; Antonella Polimeni; Iole Vozza Journal: Int J Environ Res Public Health Date: 2020-11-16 Impact factor: 3.390