Presented in part as a poster at SLEEP 2010–24th Annual Meeting of the Associated Professional Sleep Societies, LLC, San Antonio, Texas, U.S.A., June 5–9, 2010.
Article first published online: 27 JUN 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 9, pages 2115–2121, September 2012
How to Cite
Lee, S. H., Choi, J. H., Park, I. H., Lee, S. H., Kim, T. H., Lee, H. M., Park, H.-K., Thomas, R. J., Shin, C. and Yun, C.-H. (2012), Measuring sleep quality after adenotonsillectomy in pediatric sleep apnea. The Laryngoscope, 122: 2115–2121. doi: 10.1002/lary.23356
This study was supported by a grant of the Korean Healthcare Technology R&D Projects, Ministry for Health, Welfare and Family Affairs, Republic of Korea (A090084); and by a Grant-in-Aid for Scientific Research from the Communication Disorders Center of Korea University, Republic of Korea.
Robert J. Thomas, MD, has a patent on the software for cardiopulmonary analysis developed at the Beth Israel Deaconess Medical Center, Boston, Massachusetts, and licensed to MyCardio LLC/Seep Holdings LLC. Both Robert J. Thomas and Beth Israel Deaconess Medical Center receive royalties through approved institutional/Harvard Medical School royalty sharing policies.
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 23 AUG 2012
- Article first published online: 27 JUN 2012
- Accepted manuscript online: 11 APR 2012 02:29PM EST
- Manuscript Received: 5 DEC 2012
- Manuscript Accepted: 26 MAR 2012
- Manuscript Revised: 16 FEB 2012
- sleep quality;
- obstructive sleep apnea;
- Level of Evidence: 2c
The aim of this study was to demonstrate postoperative changes in sleep quality in children with obstructive sleep apnea (OSA), using both conventional sleep staging and electrocardiogram-based cardiopulmonary coupling (CPC) analysis. The hypothesis is that being electroencephalography (EEG)-independent, CPC may detect changes in sleep quality that traditional sleep architecture analysis cannot.
Retrospective outcome research.
We included 37 children (aged 6.89 ± 2.76 years, 28 male) with OSA who underwent adenotonsillectomy, and analyzed standard polysomnography and CPC parameters from a full-night study before and after adenotonsillectomy. High-frequency coupling (HFC) and low-frequency coupling (LFC) were used as indices of stable and unstable sleep, respectively.
Adenotonsillectomy led to a significant change in CPC parameters (HFC, 50.3 ± 16.1% to 56.1 ± 14.7%, P = .03; LFC, 35.1 ± 14.5% to 27.3 ± 13.0%, P = .003), which was paralleled by improvements in the apnea-hypopnea (12.7 ± 13.7 to 1.0 ± 0.8, P < .001) and arousal index (20.8 ± 11.5 to 9.9 ± 3.9, P < .001). Polysomnographic sleep stage parameters other than the arousal index did not reflect postoperative resolution of OSA.
In pediatric OSA, postoperative improvement of sleep quality is more readily discernible by CPC analysis than EEG-based sleep staging. The CPC analysis may have potential advantages in the assessment of sleep quality in pediatric populations.