Central and mixed apneas in children with obstructive sleep apnea: effect of adenotonsillectomy

Investigate the effect of adenotonsillectomy on mixed apnea index (MAI) and central apnea index (CAI) in children with moderate-to-severe obstructive sleep apnea syndrome (OSAS).

Observational retrospective analysis of polysomnographic data in children diagnosed with moderate-to-severe OSAS and without comorbidity, submitted to adenotonsillectomy.

Data were available for 80 children, 55 boys and 25 girls, with a median age of 3.6 years (2.1–5.9). Before surgery AHI was 14.1 (11.0–18.4) per hour, with a median preoperative OAI of 7.1 (4.1–10.6), MAI of 1.2 (0.6–1.6) and CAI of 1.0 (0.4–2.0). Adenotonsillectomy caused significant improvements in MAI, from 1.2 (0.6–1.6) to 0.5 (0.1–0.8) (p < 0.001) and CAI from 1.0 (0.4–2.0) to 0.5 (0.1–0.9) (p < 0.001). This represents a normalization of MAI in 91.7% and CAI in 75.6% of children that had an abnormal value prior surgery.

Non obstructive apneas are common in children with OSAS. Adenotonsillectomy caused significant decrease not only in OAI, but also in MAI and CAI in children with moderate-to-severe OSAS.