Changes in Central Sleep Apnea Index Following Pediatric Adenotonsillectomy

Abstract

Objective: Determine if there are changes in the central apnea index (CAI) when pediatric patients undergo adenotonsillectomy for obstructive sleep apnea (OSA). Method: Retrospective review conducted at 2 tertiary children’s hospitals over 10 years. Children 1 to 18 years old who underwent adenotonsillectomy for OSA and had both pre- and postoperative full-night polysomnography (PSG), with central sleep apnea (CSA) on preoperative PSG, were eligible. Criteria for diagnosis of CSA was CAI greater than 1. Results: A total of 101 children with OSA had pre- and postoperative PSG. Fifteen of these patients had preoperative CSA. Ten of the children (66.7%) were male, and the mean age was 67.7 months (SD, 62.7). The mean preoperative CAI was 3.9 (SD, 2.9), while the postoperative CAI was 1.9 (SD, 4.8). The CAI ranged from 1.1 to 11.1. There was significant improvement ( P = .008) of the CAI following adenotonsillectomy. There was also significant improvement ( P = .004) of the obstructive apnea hypopnea index (OAHI), with the mean preoperative OAHI of 22.8 (SD 19.8) decreasing to an OAHI of 5.5 (SD 6.5) postoperatively. Conclusion: Children with OSA and mild central sleep apnea on preoperative PSG showed significant improvement in the CAI following adenotonsillectomy. Future studies are needed to determine the incidence and clinical significance of central sleep apnea in children with OSA.