Impact of adenotonsillectomy on behavior in children with sleep-disordered breathing

OBJECTIVES/HYPOTHESIS: Children with sleep-disordered breathing may experience behavioral and learning problems such as inattentiveness and hyperactivity. The aim of this study was to measure the impact of adenotonsillectomy on sleep-related adverse events and behavioral problems in children with sleep-disordered breathing. METHOD: This prospective and interventional study enrolled 40 sleep-disordered breathing children (mean age, 8.4 ± 1.6 years) with hypertrophic tonsils and adenoids. All patients completed two polysomnographies, tests of variables of attention (TOVAs), and Child Behavior Checklists, one at baseline and the other 6 months after adenotonsillectomy. RESULTS: The apnea-hypopnea index (P < .001), TOVA scores (P < .001), and 8 of 9 individual domains of the Child Behavior Checklist scores (P < .05) significantly improved after surgery. However, the change in the apnea-hypopnea index was not negatively correlated with TOVA score (r = -0.17, P = .38). CONCLUSION: Adenotonsillectomy could significantly improve behavior (TOVA) scores, but the improvement may not simply be attributable to changes in sleep apnea events.