The effect of different intervention on disease outcomes and urinary leukotriene levels in pediatric sleep-disordered breathing.

Abstract

The prognosis in children with sleep-disordered breathing (SDB) undergoing adenotonsillectomy (T&A), medication, and watchful waiting with supportive care, and the changes of urine cysteinyl leukotriene E4 (uLTE4) at pretreatment and post-treatment are not well studied. Children aged 3-14 yrs suffering from SDB were enrolled. All children underwent polysomnography (PSG), completed OSA-18 Quality of Life questionnaire and uLTE4 levels were measured pre- and post-T&A, medication and watchful waiting with supportive care about six months later. Children with obstructive sleep apnea who demonstrated a resolution of disease (OAHI<1) were defined as remission. The remission in children with primary snoring (PS) was defined as the absence of snoring at the follow-up. Deterioration was defined as a progression of disease severity, such as PS progressing to OSA, mild OSA progressing to moderate-to-severe OSA, and moderate OSA progressing to severe OSA. All the others were defined as unchanged. A total of 78 children were enrolled. After treatment, 10 (50.0%), 6 (18.2%), and 7 (28.0%) children in T&A, medication, and watchful waiting were in remission respectively. PSG variables and OSA-18 Quality of Life scores were significantly improved in the T&A group and remission population. The levels of uLTE4 were not significantly different pre- and post-treatment in T&A group nor in the remission population. T&A can significantly reduce PSG variables and improve the Quality of Life in children with moderate to severe OSA. The levels of uLTE4 did not change after T&A nor in the remission population after six-month follow-up.