Magnusdottir S, Witmans M, Hilmisson H. Sleep quality, sleep apnea, and metabolic health in children treated with adenotonsillectomy. DOI: 10.1007/s11325-022-02747-3
To evaluate if cardiopulmonary coupling (CPC) calculated sleep quality (SQI) may predict changes in metabolic health in children treated with early adenotonsillectomy (eAT) for Obstructive Sleep Apnea (OSA).
Children with moderate-severe OSA and lower-SQI (Group2) increased their BMI-z score less than children with mild-OSA and higher-SQI (Group1) 0.13 vs. 0.27 (p=0.025) after surgery, improved their (p=0.025), improved their SQI +2.06 compared to decline -3.75 in Group1, (p=0.015), decreased AHRSleep -2.90 vs. -0.34 (p=0.025) and AHI -5.00 vs. -0.36 (p=0.002).
Children that had remission of their OSA and high-SQI after surgery (GropupRemission) was younger 6.59 vs. 7.41; p<0.001; with lower BMI z-score 0.90 vs. 1.34;p=0.021; AHRSleep 80.60 vs. 83.50;p=0.032; fasting insulin (µIU/ml) 7.54 vs. 12.58;p=0.017 and glucose (mmol/L) 4.45 vs. 4.60;p=0.049, with better lipid metabolism though not significantly, low-density-lipoprotein 90.26 mg/dL vs. 97.94;p=0.081 and cholesterol 154.66 mg/dL vs. 164.36;p=0.076 compared to the children with OSA (AHI>1) and lower-SQI at 7-month follow-up.
The results may indicate that children with mild-OSA and high-SQI may be less likely to benefit from eAT than children with moderate-OSA. To improve metabolic health, successfully treating both AHI and SQI is likely needed. CPC-calculated SQI may have a role to identify children less likely to benefit from eAT and to evaluate success of therapy.