Effect of adenotonsillectomy on sleep problems, attention deficit hyperactivity disorder symptoms, and quality of life of children with adenotonsillar hypertrophy and sleep-disordered breathing

Abstract

Objective Chronic adenotonsillar hypertrophy is the most common etiologic reason for upper airway obstruction in childhood and has been found to be associated with a variety of psychiatric disorders and poor quality of life. In the present study, we investigated the impact of adenotonsillectomy on attention deficit hyperactivity disorder symptoms, sleep problems, and quality of life in children with chronic adenotonsillar hypertrophy. Methods The parents of children with chronic adenotonsillar hypertrophy filled out the Conners’s Parent Rating Scale-Revised Short form (CPRS-RS), Children’s Sleep Habits Questionnaire (CSHQ), and Pediatric Quality of Life Inventory, Parent version (PedsQL-P) before and six months after adenotonsillectomy. Results A total of 64 children were included in the study (mean age = 6.8 ± 2.4 years; boy:girl ratio= 1). The mean attention deficit hyperactivity disorder index and oppositionality subdomain scores of the CPRS-RS and all of the CSHQ subdomain scores (bedtime resistance, sleep-onset delay, sleep anxiety, night waking, parasomnias, sleep-disordered breathing, and daytime sleepiness) except for sleep duration significantly decreased after adenotonsillectomy ( p < 0.05). The PedsQL-P total score and both PedsQL-P physical health and psychosocial health subdomain scores were significantly higher at six months after adenotonsillectomy ( p < 0.001). Conclusions Child and adolescent psychiatrists should check the symptoms of chronic adenotonsillar hypertrophy to identify children with chronic adenotonsillar hypertrophy who suffer from sleep disturbance, attention deficit hyperactivity disorder symptoms, and oppositionality. Adenotonsillectomy seems to be beneficial for coexisting attention deficit hyperactivity disorder and sleep disorder symptoms and quality of life in these children.

Evaluation of Pharyngeal Airway Dimensions and Hyoid Bone Position in Children After Adenoidectomy or Adenotonsillectomy: A Cephalometric Study

“…In addition, a significant increase in the physiological development, psychosocial development, and quality of life of children has been reported after adenotonsillectomy. 22 - 24 …”

A review of health—related quality of life issues in children suffering from certain key otolaryngological illnesses

“…A very strong correlation was also found between such constraints with limitations on parents' free time. As an aside and beyond the scope of this review, it should however be noted that studies on patients suffering from sleep apnea syndrome form a quite considerably large group of articles regarding the quality of life in ENT patients ( 23 – 25 ).…”

Health-Related Quality of Life in Children Hospitalised Due to Four Ent Illnesses: A Selective Review

“…Studies have mainly investigated children's health status before and after an applied treatment by using detailed questionnaires. In many countries, recurrent tonsillitis and tonsil hypertrophy (and its complications) are recognized as reducing the quality of life of affected children [19][20][21][22][23][24][25][26][27][28][29]. These studies emphasize that limitations in a child's health affect joint family activities, physical activity, general health, behaviour, and family emotions.…”

“…A very strong correlation has also been found between such constraints and limitations on the parents' free time. As an aside, and beyond the scope of this review, it should be noted that studies on patients suffering from sleep apnea syndrome are the focus of many articles looking at the quality of life in ENT patients [23][24][25].…”

“…Furthermore, an enlarged adenoid may impair the patency of the Eustachian tube which, inter alia, can lead to exudative otitis media, that may lead to hearing loss [49][50][51][52][53][54][55]. Symptoms of tonsil hypertrophy are snoring, obstructive sleep apnea syndrome, speech disorders such as slurred speech, and dysphagia (especially with solid foods) [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]51,55].…”