Effects of an adenotonsillectomy on the cognitive and behavioural function of children who snore

A naturalistic observational study

Khalid Al-Zaabi, Samir al-Adawi, Sanjay Jaju, Lakshmanan Jeyaseelan, Nasser Al-Sibani, Mohammed Al-Alawi, Mohammed Al-Abri, Rashid Al-Abri

Research output: Contribution to journalArticle

Abstract

Objectives: This study aimed to evaluate cognitive and behavioural changes among 9–14-yearold Omani children with obstructive sleep apnoea (OSA) after an adenotonsillectomy (AT). Methods: This naturalistic observational study was conducted at the Sultan Qaboos University Hospital, Muscat, Oman, between January 2012 and December 2014. Omani children with adenotonsillar hypertrophy (ATH) underwent overnight polysomnography and those with confirmed OSA were scheduled for an AT. Cognitive and behavioural evaluations were performed using standardised instruments at baseline prior to the procedure and three months afterwards. Results: A total of 37 children were included in the study, of which 24 (65%) were male and 13 (35%) were female. The mean age of the males was 11.4 ± 1.9 years, while that of the females was 11.1 ± 1.5 years. Following the AT, there was a significant reduction of 56% in mean apnoea-hypopnoea index (AHI) score (2.36 ± 4.88 versus 5.37 ± 7.17; P <0.01). There was also a significant positive reduction in OSA indices, including oxygen desaturation index (78%), number of desaturations (68%) and number of obstructive apnoea incidents (74%; P <0.01 each). Significant improvements were noted in neurocognitive function, including attention/concentration (42%), verbal fluency (92%), learning/recall (38%), executive function (52%) and general intellectual ability (33%; P <0.01 each). There was a significant decrease of 21% in both mean inattention and hyperactivity scores (P <0.01 each). Conclusion: These results demonstrate the effectiveness of an AT in improving cognitive function and attention deficit hyperactivity disorder-like symptoms among children with ATH-caused OSA. Such changes can be observed as early as three months after the procedure.

Original languageEnglish
Pages (from-to)e455-e460
JournalSultan Qaboos University Medical Journal
Volume18
Issue number4
DOIs
Publication statusPublished - Nov 1 2018

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Obstructive Sleep Apnea
Cognition
Observational Studies
Apnea
Hypertrophy
Oman
Aptitude
Polysomnography
Executive Function
Attention Deficit Disorder with Hyperactivity
Learning
Oxygen

Keywords

  • Adenoidectomy
  • Attention Deficit Hyperactivity Disorders
  • Behavior
  • Children
  • Cognitive Function
  • Obstructive Sleep Apnea
  • Oman

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of an adenotonsillectomy on the cognitive and behavioural function of children who snore : A naturalistic observational study. / Al-Zaabi, Khalid; al-Adawi, Samir; Jaju, Sanjay; Jeyaseelan, Lakshmanan; Al-Sibani, Nasser; Al-Alawi, Mohammed; Al-Abri, Mohammed; Al-Abri, Rashid.

In: Sultan Qaboos University Medical Journal, Vol. 18, No. 4, 01.11.2018, p. e455-e460.

Research output: Contribution to journalArticle

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abstract = "Objectives: This study aimed to evaluate cognitive and behavioural changes among 9–14-yearold Omani children with obstructive sleep apnoea (OSA) after an adenotonsillectomy (AT). Methods: This naturalistic observational study was conducted at the Sultan Qaboos University Hospital, Muscat, Oman, between January 2012 and December 2014. Omani children with adenotonsillar hypertrophy (ATH) underwent overnight polysomnography and those with confirmed OSA were scheduled for an AT. Cognitive and behavioural evaluations were performed using standardised instruments at baseline prior to the procedure and three months afterwards. Results: A total of 37 children were included in the study, of which 24 (65{\%}) were male and 13 (35{\%}) were female. The mean age of the males was 11.4 ± 1.9 years, while that of the females was 11.1 ± 1.5 years. Following the AT, there was a significant reduction of 56{\%} in mean apnoea-hypopnoea index (AHI) score (2.36 ± 4.88 versus 5.37 ± 7.17; P <0.01). There was also a significant positive reduction in OSA indices, including oxygen desaturation index (78{\%}), number of desaturations (68{\%}) and number of obstructive apnoea incidents (74{\%}; P <0.01 each). Significant improvements were noted in neurocognitive function, including attention/concentration (42{\%}), verbal fluency (92{\%}), learning/recall (38{\%}), executive function (52{\%}) and general intellectual ability (33{\%}; P <0.01 each). There was a significant decrease of 21{\%} in both mean inattention and hyperactivity scores (P <0.01 each). Conclusion: These results demonstrate the effectiveness of an AT in improving cognitive function and attention deficit hyperactivity disorder-like symptoms among children with ATH-caused OSA. Such changes can be observed as early as three months after the procedure.",
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