Complete Airway Obstruction Research Articles

Metabolomic approach for obstructive sleep apnea in adults: a systematic review.

Obstructive Sleep Apnea (OSA) corresponds to episodes of complete or partial upper airway obstruction during sleep. The gold standard for diagnosing OSA is polysomnography; however, metabolomics is an innovative and highly sensitive method that seeks to identify and quantify small molecules in biological systems. Identify the metabolites most frequently associated with obstructive sleep apnea in adults. The search for articles was conducted between October 2020 and August 2021, in electronic databases, such as MEDLINE/PubMed, Scielo, Embase, and Cochrane, through the combination of descriptors: obstructive sleep apnea, metabolomic, adult. This systematic review included all cross-sectional studies published, including human patients aged 18years or older, of both genders who underwent type I or II polysomnography and metabolomics study. The search strategy selected 3697 surveys, and 4 of them were selected to be a part of this systematic review. Based on the analyzed surveys, it was found that all of them were able to diagnose OSA, reaching a sensitivity of 75-97%, and specificity that ranged from 72 to 100%; besides differentiating patients with OSA (severe, moderate, and mild) from simple snorers with a mean sensitivity of 77.2% and specificity of 66.25%. These findings suggest that, in addition to being used as a screening and diagnostic strategy for OSA, metabolomics has the potential to be used for severity stratification and to monitor the disease's progression.

Chest Physiotherapy as an Adjunct in a Mechanically Ventilated Infant with Atelectasis: A Case Report

Atelectasis occurs due to impaired airway clearance or complete airway obstruction caused by inflammation, leading to the collapse of tiny airways either partially or completely. This results in impaired exchange of carbon dioxide and oxygen. A chest X-ray, Computed Tomography (CT), and/or thoracic ultrasound are helpful in identifying atelectasis. In the present case, a 5-month-old female infant was reported to the Paediatric Department with the chief complaint of seizure and loss of consciousness. An X-ray was performed, revealing complete left lung atelectasis with no air entry. The infant was referred for physiotherapy in addition to medical management. Through seven intensive and regular sessions of respiratory physiotherapy, which included techniques such as percussion, vibration, and postural drainage for more than 30 minutes, there was successful resolution of the consolidation and improvement in presenting symptoms. After the final sessions of physiotherapy, the infant was discharged with physiotherapy home programs. This suggests that physiotherapy is an integral part of paediatric critical care, ensuring a good prognosis and faster recovery.

The criminal offense of counterfeiting money in France from the revolution to the end of the 19th century

Introduction. General anesthesia is frequently employed in neck surgery procedures. However, in patients at high risk for general anesthesia, regional anesthesia options, such as the superficial cervical plexus block, warrant careful consideration. Patients with mediastinal lymph node enlargement face an elevated risk of airway obstruction and hemodynamic mediastinal instability during anesthesia induction. In selected neck surgeries, including thyroglossal cyst excision, thyroglossal fistula repair, bronchial cyst removal, thyroidectomy, and lymph node excision, the superficial cervical plexus block presents a viable and secure alternative to general anesthesia. Case report. This report details the case of a patient with mediastinal lymphadenopathy and multiple brain metastases who underwent cervical lymph node excision. Given the patient?s severe comorbidities, pronounced risk of complete distal airway obstruction, hemodynamic instability, and the potential for compression effects from mediastinal mass, a superficial cervical block was administered. This block facilitated effective perioperative analgesia without inducing respiratory or cardiovascular instability. Conclusion. The superficial cervical plexus block emerges as a prudent alternative to general anesthesia in high-risk patients necessitating cervical lymph node excision procedures. Its utilization should be considered in such cases to enhance patient safety and perioperative management.

Cervical plexus block - safe anesthesia for the patients with massive mediastinal lymphadenopathy

Introduction. General anesthesia is frequently employed in neck surgery procedures. However, in patients at high risk for general anesthesia, regional anesthesia options, such as the superficial cervical plexus block, warrant careful consideration. Patients with mediastinal lymph node enlargement face an elevated risk of airway obstruction and hemodynamic mediastinal instability during anesthesia induction. In selected neck surgeries, including thyroglossal cyst excision, thyroglossal fistula repair, bronchial cyst removal, thyroidectomy, and lymph node excision, the superficial cervical plexus block presents a viable and secure alternative to general anesthesia. Case report. This report details the case of a patient with mediastinal lymphadenopathy and multiple brain metastases who underwent cervical lymph node excision. Given the patient?s severe comorbidities, pronounced risk of complete distal airway obstruction, hemodynamic instability, and the potential for compression effects from mediastinal mass, a superficial cervical block was administered. This block facilitated effective perioperative analgesia without inducing respiratory or cardiovascular instability. Conclusion. The superficial cervical plexus block emerges as a prudent alternative to general anesthesia in high-risk patients requiring cervical lymph node excision procedures. Its utilization should be considered in such cases to enhance patient safety and perioperative management.

Vocal Cord Edema Leading to Complete Airway Obstruction in a Case of Traumatic Difficult Airway

A 31-year-old male had presented to the emergency department after road traffic accident. Primary investigation revealed presence of right clavicle fracture, bilateral LeFort 2 and 3 fractures along with displaced mandible. He was intubated in view of poor GCS and threatened airway.

Acute Epiglottitis in a Patient with COVID-19 and C1 Esterase Deficiency: A Case Report

Coronavirus disease 2019 (COVID-19) has been associated with the rare, yet potentially fatal, condition known as epiglottitis. Epiglottitis has the potential to lead to complete airway obstruction, and often constitutes emergent management. Here, we describe a case of acute epiglottitis in a 19-year-old man infected with COVID-19 with a past history of angioedema.

Obstructive Sleep Apnea and Positive Airway Pressure Usage in Populations with Neurological Disease.

Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial upper airway obstruction during sleep, with a worldwide estimate of 936 million sufferers. Treatments of OSA include continuous positive airway pressure (CPAP), weight loss, positional therapy, oral appliances, positive upper airway pressure, oro-maxillofacial surgery, hypoglossal nerve stimulation, and bariatric surgery, and others, with CPAP being the most commonly prescribed treatment. In this review, the neurologic conditions of stroke, cognitive decline, epilepsy, and migraines will be discussed as they relate to OSA. Additionally, the literature regarding improvement in these conditions following treatment with CPAP will be explored.

Effects of inspiratory muscle training in patients with obstructive sleep apnoea syndrome: a systematic review and meta-analysis.

Obstructive sleep apnoea (OSA) is a common disorder marked by repetitive occurrence of breathing cessation during sleep due to partial or complete upper airway obstruction. An obstructive airway and the successive asphyxia chronically overload the inspiratory muscles resulting in an increased inspiratory effort. The present systematic review aimed to examine the effects of inspiratory muscle training (IMT) on inspiratory muscle strength [maximal inspiratory pressure (PImax)], severity of disease [apnea hypopnoea index (AHI)], sleep quality [Pittsburgh sleep quality index (PSQI)], day time sleepiness [Epworth sleepiness scale (ESS)], lung function [forced expiratory volume in 1 second (FEV1)] and exercise capacity [cardiopulmonary exercise testing, (CPET), 6 minute walk test, (6MWT)] in mild to severe OSA. Among 953 articles retrieved from various databases (PubMed, SCOPUS, Web of Science and Cochrane), 7 articles were found to be eligible for the present review. Randomized controlled trials reporting the effect of IMT in OSA were selected. The quality assessment was conducted using Cochrane risk-of-bias tool for randomized trials. All seven studies were meta-analyzed. The result depicted significant change in PImax, ES 1.73 (95%CI 0.54 to 2.92, p=0.004), PSQI -1.29 (95%CI -1.94 to -0.65, p<0.0001), ESS -1.08 (95% CI -1.79 to - 0.37, p=0.003) and FEV1 0.74 (95%CI 0.20 to 1.28, p=0.007). IMT may be considered as an effective treatment strategy in mild to severe OSA resulting in improved inspiratory muscle strength, sleep quality, daytime sleepiness, and lung function. However, there is still dearth evidence on repercussion of IMT on lung function and exercise capacity and warrants high quality evidence to reach definitive conclusions.

The Nature, Frequency, and Timing of Pediatric Sedation Adverse Events.

The nature and frequency of pediatric sedation adverse events (AEs) have been well described. However, the timing of specific AEs in induction, procedure, and recovery phase of sedation remains unknown. The objective was to describe the nature, frequency, and timing of AEs. We hypothesized that most AEs would start at the induction phase. We examined prospectively collected data of sedation encounters of children 3 months to 18 years of age, characterized by at least 1 AE, from January 1, 2013 to December 31, 2020. Patient characteristics, primary diagnosis, procedure type, nature, frequency, and timing of AEs were reported. Of 12 012 sedation encounters, the mean age was 7.6 (SD = 4.9) years, most (89%) were American Society of Anesthesiologists II risk, the most common diagnosis was hematology/oncology (27.3%) and the most common procedure radiologic (47.8%). At least 1 AE occurred during 765 (6.4%) encounters. Respiratory AEs were most common (n = 645, 5.4% of all encounters) and started more often during induction (64.5% of respiratory AEs). Partial upper airway obstruction was the most common respiratory AE (2.8% of all encounters). Partial (59.4%) and complete (77.3%) upper airway obstruction and apnea (84%) all began more often during induction. Laryngospasm (48.4% vs 46.8%) and hypoxemia (59.3% vs 39%) were similarly distributed between induction and procedure, respectively, though they were rare during recovery. Most respiratory events in this cohort started during the induction or procedure phases. The sedation team should be especially prepared to administer rescue maneuvers and allocate staff/resources during these phases.

A case of unexpected intraoperative airway obstruction in a patient with an aneurysm of the ascending aorta and aortic arch.

Upper airway compression is one of the clinical manifestations of thoracic aortic aneurysm, which is associated with poor prognosis and high mortality. A 44-year-old patient with ascending aortic and arch aneurysm who was scheduled for Bentall surgery and total arch replacement under cardiopulmonary bypass suffered difficult ventilation after endotracheal intubation. The patient did not exhibit any positional dyspnoea or orthopnoea, did not show any difficulties in the supine position, and had no noteworthy medical history. However, we encountered unexpected hypoventilation after intubation. Isoprenaline infusion was effective while emergency cardiopulmonary bypass was established to deal with this crisis. Fibreoptic bronchoscopy revealed complete obstruction of the carina and confirmed the supracarinal position of the tube. Complete airway obstruction may occur even if there are no symptoms before surgery in patients with thoracic aortic aneurysm. Comprehensive preoperative assessment, a well-developed airway management plan, and responses to possible emergencies are essential to reduce unnecessary events or complications.

Long Standing Foreign Body lodged in the Right Bronchial Tree – A Case Report

Foreign body inhalation is a life threatening emergency condition that commonly occur in children. A foreign body (FB) can be lodged in either the upper or lower airway or cause either a partial or complete airway obstruction. Complete obstruction of upper airway is a potentially life-threatening situation that causes severe respiratory distress and suffocation. Lower airway FB typically manifests with sudden-onset coughing and choking, followed by wheezing and dyspnea. We are presenting a case report of 3years old female child with a foreign body in the right bronchus intermediacy over one year. Patient was managed by performing thoracotomy after failed rigid bronchoscopy. This case is importance as to reduce the frequency of prescribing without throughout investigations.

Difficult Ventilation in an Infant After Successful Intubation.

Manufacturing defects in the connector of the endotracheal tube are not frequently encountered in emergency and planned intubations. In cases where they are encountered, however, they may cause partial or complete airway obstruction in sick infants with limited reserves, giving rise to a life-threatening situation following the intubation. For this reason, endotracheal tubes must be checked carefully before use. To this end, a stylet can be passed through the tube to check for a defect in the tube lumen or tube connector as part of a routine check of an endotracheal tube. This report features a patient who experienced a complete airway obstruction following intubation due to a manufacturing defect in the connector of the endotracheal tube.

Ventilation through a straw.

Transtracheal jet ventilation can be used for resuscitation of partial airway obstruction. A prerequisite for jet ventilation is that at least a minimum airway opening for gas escape must be secured. Therefore, another option should be considered in cases of complete airway obstruction. The following methods or devices has been used under cricothyrotomy using an intravenous cannula: 1) Ambu (bag valve mask) bagging, 2) Ventrain®, 3) Rapid-O2 oxygen insufflation device (Rapid-O2), and 4) jet ventilation using a dual lumen catheter. During Ambu bagging, extraordinarily high insufflation pressure is required to force oxygen through the cannula. When using a 12-G cannula, long and slow positive-pressure ventilations (10–12 breaths/min) are required, which makes it extremely difficult to compress the bag. Therefore, a 10-G or larger is recommended. Ventrain® is an expiratory assist device capable of forcibly expelling insufflated oxygen through a transtracheal cannula. It is recommended to adjust the inspiratory and expiratory times while observing the chest wall movements. Rapid-O2 is a rescue oxygenation device with adequate ventilation of less importance; therefore, the resulting hypercarbia is inevitable. A 14-G cannula is used. Lastly, jet ventilation using a dual-lumen catheter with a 16-G inflow lumen and 10-G outflow lumen was used to obtain both oxygenation and ventilation. However, the addition of the outer diameters of 16-G and 10-G results in an outer diameter of 5.1 mm, which is too large to puncture the cricothyroid membrane. In conclusion, Ventrain® is considered the most ideal device for use among the devices developed to date.

0544 Polysomnography characteristics of children with obesity: A single center retrospective study

Abstract Introduction The constellations of symptoms known as obstructive sleep apnea (OSA) results from either partial or complete airway obstruction during sleep. This affects effective gas exchange and disrupts sleep architecture resulting in sleep fragmentation with downstream immediate and long-term adverse effects. Obesity is a significant risk factor in childhood OSA, especially in post-pubertal children. Obese/overweight children have been found to have significantly higher rates of OSA than their normal-weight counterparts, independent of tonsillar size. Polysomnography characteristics (PSG) comparing children with obesity with and without comorbidities (Hypertension, Diabetes or Pre-diabetes) has not been previously described. Methods Retrospective analysis of 190 obese children (BMI&amp;gt;95th centile), age between 7-18 years with AHI ≥5/hour met the criteria for the data analysis. Clinical, demographic and PSG parameters of children with obesity with and without co-morbidities were compared using Wilcoxon rank sum test. Correlation (Spearman non-parametric) and regression model was employed to explore associations between demographic and PSG characteristics. Results Majority of the obese children (mean BMI 33.2) had mild OSA, with no significant difference in AHI between the two groups. Children with obesity and comorbidities were older with higher BMI. There was no difference in BMI between the two groups after adjusting for BMI z scores. AHI increased with increasing BMI centiles. In our regression model, peak ETCO2 was associated with Black race, AHI, rhinitis and inversely associated with asthma. Peak ETCO2 increased with BMI. Oxygen at baseline, nadir and desaturation duration inversely correlated with BMI-centiles. Older children had lower O2 nadir. Black race was associated with higher desaturation, supine AHI, and arousal index. Supine AHI was higher with rhinitis. Average heart rate when awake, NREM and REM increased with higher BMI. Conclusion In our study, majority of the children had mild OSA with no significant difference in AHI between obese children with and without comorbidities. AHI, average heart rate and peak ETCO2 increased with BMI. O2 nadir was lower in older children and with higher BMI. Black race was associated with higher peak ETCO2, higher desaturation and supine AHI. Children with obesity and comorbidities were older with higher BMI suggesting synergistic effect of BMI and duration of obesity. Support (If Any)

0541 Auto PAP adherence determinants of children during the pandemic: A single center experience

Abstract Introduction Obstructive sleep apnea (OSA) is characterized by episodes of partial or complete upper airway obstruction, associated with gas exchange abnormalities, and sleep disruption resulting in OSA syndrome. OSA in majority of children improves after adenotonsillectomy, but with comorbidities or severe OSA, there is a high risk of residual OSA. Positive airway pressure (PAP) is a more definitive therapy for residual OSA when well tolerated. Reported CPAP adherence in children varies from 11-78%, but data on AutoPAP (APAP) acceptability and adherence has not been described. Methods Due to the limitations placed on PAP titration during the SARS-COV-2 pandemic, children (range 2-18 years) diagnosed with OSA at our institution were placed on APAP therapy (Auto CPAP or Auto BiPAP). We performed a retrospective analysis of APAP download data of children who met the criteria (adherence at 90 days&amp;gt;4 hours). Adherent (usage&amp;gt;70%) and non-adherent children were compared using Wilcoxon rank sum test. Logistic regression analyses were performed the effect of covariates including age, PSG AHI, Day 1-7 usage, Day 1-7 residual AHI, Day 1-14 usage, Day 1-14 residual AHI, Day 1-30 usage, Day 1-30 residual AHI or mean pressure at 90 day on compliance at 90 days. Results On day 90, 73 out of 90 children (40 boys) were using APAP &amp;gt;4 hours. Age, diagnostic PSG AHI, residual AHI (days 1-7; 1-14, 1-30), APAP median pressure, pressure (95% centile), and pressure (maximum) had no effect on adherence. Adherence at days (1-7; 1-14; 1-30) and day 1-90 residual AHI had a positive effect on adherence at day 90. There was no statistically significant difference in BMI z-score, age, PSG AHI, median pressure between the two groups. However, residual AHI was lower in the compliant group. Conclusion APAP was fairly well accepted in our study with the majority of children with usage &amp;gt; 4 hours at day 90. Adherence on (days 1-7 and 1-30) predicted APAP usage at day 90. This mirrors adherence data from adult OSA patients. APAP was effective in the compliant group with lower residual AHI. Further analysis of adherence characteristics such as; family history of PAP, PAP mode, mask, surgery and comorbidities is planned. Support (If Any)

Dynamic Obstruction due to Unfurling of Spirals in a Flexometallic Tube.

Flexometallic tubes are kink-resistant and extensively used in neurosurgeries. The manufacturers of flexometallic tubes recommend single usage. In low-income countries, due to the cost restraints, flexometallic tubes are commonly reused after ethylene oxide sterilization. With this technique, flexometallic tubes are effectively sterilized, but the physical integrity of the endotracheal tube cuffs may be compromised.1 Tube kinking2 and intraluminal blebs due to dissection3 are observed with the reused flexometallic tubes. These obstructions lead to difficulty in ventilation and inability to pass a suction catheter freely. Flexometallic tubes should be thoroughly checked for external deformity, cuff integrity, and tube patency for safe reuse.Despite thorough assessment of reused flexometallic tubes, the partial unfurling of nylon spirals with distal herniation into the tube (fig.) may still happen intraoperatively, leading to dynamic obstruction resulting in variable resistance during suction catheter negotiation (see Supplemental Digital Content 1, video S1, http://links.lww.com/ALN/C848). Along with the heavy weight of the circuit, the varied positions of head and neck result in additional rotational bending of flexometallic tubes, contributing to partial unfurling, which may not cause complete airway obstruction but can lead to difficult ventilation requiring airway change. The simple technique of passing a suction catheter through flexometallic tubes can help in identifying such partial tube obstruction. Reinforced tracheostomy tubes are also frequently reused after a thorough cleaning and visual inspection.Adhering to the manufacturer’s recommendation regarding reuse is the best way to prevent these complications. However, when clinically necessary and under the right circumstances only, flexometallic tubes should be reused after a thorough assessment.The authors are thankful to the patient who consented to publish the current article. The authors are also thankful to all anesthesia technicians who helped them ensure patient safety.The authors declare no competing interests.

Complete airway obstruction relieved with bilateral chest compression in a morbidly obese patient with undiagnosed hypertrophic mucosa and severe edema of arytenoids

Complete airway obstruction relieved with bilateral chest compression in a morbidly obese patient with undiagnosed hypertrophic mucosa and severe edema of arytenoids

Screening for Obstructive Sleep Apnea in the Long-Term Care Setting

<h3>Introduction</h3> Obstructive sleep apnea (OSA) is a primary sleep disorder that is characterized by partial or complete airway obstruction secondary to airway collapse. It results in momentary periods of involuntary respiratory cessation during sleep causing intermittent hypoxia and oxidative stress (1). It is also recognized as a risk factor for medical comorbidities such as hypertension, diabetes, and strokes (1). Furthermore, OSA is thought to be an independent risk factor for mental illnesses such as depression and cognitive impairment and can mirror or worsen symptoms of neurocognitive disorders like Alzheimer's disease (2). OSA is thought to increase the risk of Alzheimer's disease, while patients with Alzheimer's may have an elevated risk of developing OSA which in turn might contribute to a quicker progression of their cognitive decline (3). The primary objective of this study is to determine if a correlation between OSA and declining cognitive functions exists among patients in long-term care facilities. Compared to the general population who reside in community settings, sleep disturbances are more common and more severe in patients who are in nursing homes (4). Few studies have investigated the prevalence of OSA in long-term care among residents in skilled nursing facilities. It is important to screen both cognitively impaired and intact individuals for OSA in the long-term care setting. Prompt screening and diagnosis with subsequent initiation of appropriate treatment may result in reversal and/or resolution of cognitive changes associated with this disorder and improve the patients' overall functionality and quality of life (5). <h3>Methods</h3> This is an investigator-initiated, observational cross-sectional study. Subject enrollment took place during June 2019 - November 2021. No randomization was required. We utilized 2 scales: a brief and practical questionnaire called the STOP-BANG to screen for OSA with scores of 3-4 conferring intermediate risk while scores of 5-8 considered high risk for OSA. The Saint Louis University Mental Status (SLUMS) examination was used to determine cognitive status with higher scores correlating with better cognition. Data acquired was compared between residents who suffered from impaired cognition with those who were cognitively intact. No treatment or intervention was administered to patients. Long-term care residents and their families were approached for consent to participate in the study. The study was approved by the St. Louis University School of Medicine IRB. Sociodemographic information and history regarding diagnosis and/or treatments for OSA and neurocognitive disorders was collected from patients' charts. Medical information relative to comorbidities such as hypertension, diabetes mellitus, smoking, stroke history, hyperlipidemia, and coronary artery disease was also collected from patient charts. <h3>Results</h3> A total of 84 participants, aged 51 to 97, were recruited from June 2019 to November 2021. Of the patients recruited, 21 were cognitively intact with a mean age of 71.3 years, BMI of 35.2 kg/m², and STOP-BANG score of 4.5; 42 had mild cognitive impairment with a mean age of 75.9 years, BMI of 29.8 kg/m², and STOP-BANG score of 3.7; 21 had major neurocognitive disorder (dementia) with a mean age of 82.7, BMI of 27.0 kg/m², and STOP-BANG score of 3.9. We found that the association between preserved cognitive functions, as measured by the SLUMS and lower risk of OSA as measured by the STOP-BANG was not statistically significant (p=.104 per Chi-Square testing). When the data was further stratified, patients with preserved cognition were younger in age and found to have statistically significant higher BMI (p<0.05) as well as higher STOP-BANG scores (p<0.05). Further, patients with normal cognition had a higher prevalence of diabetes, coronary artery disease, hyperlipidemia, and smoking when compared to cognitively impaired patients. <h3>Conclusions</h3> Given that older age is a risk factor for cognitive decline, patients in our study with normal cognition were notably younger in age; however, they were found to have more medical comorbidities. These patients also had higher BMI scores and a higher neck circumference which correlates with a higher risk for OSA. Conversely, patients with lower SLUMS scores were older, had lower risk for OSA, and had fewer medical comorbidities, including lower BMI and lower neck circumference. In conclusion, younger patients with normal cognition may be in nursing homes due to their multiple, severe medical comorbidities. As previously stated, more medical comorbidities confer a higher risk for OSA. Overall, small sample size and the diagnostic precision of the SLUMS exam are limitations of this study. Future directions would include further studies with larger sample sizes to evaluate the interplay of medical comorbidities in developing OSA and subsequent cognitive decline, specifically within nursing homes.

Complete Airway Obstruction and Massive Hemorrhage from Post-Thyroidectomy Neck Hematoma: A Case Report and Management Algorithm

Postoperative Neck Hematoma (PONH) is a potentially life-threatening complication of neck/thyroid procedures due to massive hemorrhage and/or acute airway compromise (often associated with difficult airway management) requiring immediate surgical re-intervention. Patient survival often relies on optimal crisis resource management skills of the care team. We describe the case of a PONH in an elderly patient in the immediate post-thyroidectomy period, presenting with acute respiratory failure/arrest and massive hemorrhage with hemodynamic instability. We outline the approach taken to successfully manage this emergency and highlight critical management steps including the leadership role of the anesthesiologist that ultimately resulted in a positive outcome.

Measurement of snoring and stertor using the Sonomat to assess effectiveness of upper airway surgery in children.

The success of surgical treatment for pediatric sleep-disordered breathing is typically assessed using the mixed and obstructive apnea-hypopnea index (MOAHI). Although an important metric, previous work has shown that snoring and stertor are also associated with sleep disruption. Our aim was to assess the efficacy of surgery using the Sonomat (Sonomedical Pty Ltd), a noncontact sleep assessment system, that accurately records complete and partial upper airway obstruction. Forty children (< 18 years) had a Sonomat study, in their own beds, before and after surgery. As an MOAHI ≥ 1 event/h is considered abnormal, the same threshold was applied to snore/stertor runs. Median (interquartile range) values are reported. Respiratory event-induced movements decreased from 12.0 (8.7-19.0) to 0.5 (0.1-3.2) events/h (P < .01), with no significant change in spontaneous movements: 12.8 (9.8-17.9) to 16.5 (13.7-26.1) events/h (P = .07). The MOAHI decreased from 4.5 (1.9-8.6) to 0.0 (0.0-0.4) events/h (P < .01). Snoring and/or stertor runs decreased from 32.8 (23.4-44.4) to 3.0 (0.2-14.6) events/h (P < .01). Thirty-four children had an MOAHI < 1 event/h following surgery; however, 20 had snore and/or stertor runs ≥ 1 event/h and 11 had snore and/or stertor runs ≥ 5 events/h. Only 14 (35%) children had a postsurgery MOAHI < 1 event/h combined with snoring and/or stertor < 1 runs/h. Although surgery is effective in improving breathing, success rates are overestimated using the MOAHI. Our results indicate that snoring and/or stertor are still present at levels that may disrupt sleep despite a normalization of the MOAHI and that when obstructed breathing was objectively measured, there was a large variation in its response to surgery. Norman MB, Harrison HC, Sullivan CE, Milross MA. Measurement of snoring and stertor using the Sonomat to assess effectiveness of upper airway surgery in children. J Clin Sleep Med. 2022;18(6):1649-1656.