Prevalence of Symptoms of Obstructive Sleep Apnoea in Children Undergoing Routine Adenotonsillectomy

Introduction: Obstructive sleep apnoea (OSA) is a condition characterized by episodic partial or complete obstruction of the upper airway during sleep leading to apnoea or cessation of breathing. Obstruction of the upper airway during sleep may result in the generation of noise (snoring), reduction (hypopnoea) or cessation (apnoea) of airflow at the nostrils and mouth. There are multiple indications for undertaking a patient for adenoidectomy and/or tonsillectomy with obstructive sleep apnoea (OSA) being one among many. Objective: The aim of the present study was to find the prevalence of OSA symptoms in children undergoing adenotonsillectomy for indications other than that of obstructive sleep apnoea. Material & Methods: The study was conducted in the Department of ENT and Head & Neck surgery, Gauhati Medical College & Hospital, Guwahati for a period of one year. Twenty six patients who underwent adenoidectomy and/or tonsillectomy during this period were selected for the study. The parents of the patients were administered the Paediatric Sleep Questionnaire pre-operatively and the patients were evaluated for any symptoms of OSA. A score of 8 or more was suggestive of presence of breathing related sleep disorder. All statistical analyses were performed using statistical software SPSS 16.0 version. To test for the difference in the proportion between different variables, chisquare/fisher exact test where appropriate were employed. All statistical tests were two tailed with 0.05 as the threshold level of significance. Results: 11 children (42.3%) had a score of 8 or more out of the 26 children in Paediatric sleep questionnaire. The chi square for this was 4.696 with a p value of 0.096. The snoring subscale was found to be positive in 19 children (73.1%). All children with score of 8 or more were positive for the snoring scale. The sleepiness subscale was found to be positive in 14 children (53.8%). 10 of the 11 children were positive for sleepiness scale among the children who had a score of 8 or more in the questionnaire. These were found to be statistically significant. Conclusion: A significant population of the children undergoing routine adenotonsillectomy also has symptoms of obstructive sleep apnoea. The pathophysiology of obstructive sleep apnoea should be borne in mind in all children having adenotonsillar hypertrophy and a prompt and early intervention into these children should be aimed for both the infective etiology and the possible outcomes of their compromise to the airway column for a better quality of life.