PT  - JOURNAL ARTICLE
AU  - Xiao Liu
AU  - Sarah Immanuel
AU  - Yvonne Pamula
AU  - Declan Kennedy
AU  - James Martin
AU  - Mathias Baumert
TI  - Adenotonsillectomy for childhood obstructive sleep apnoea reduces thoraco-abdominal asynchrony but spontaneous apnoea−hypopnoea index normalisation does not
AID  - 10.1183/13993003.01177-2016
DP  - 2016 Nov 03
TA  - European Respiratory Journal
PG  - ERJ-01177-2016
4099  - http://erj.ersjournals.com/content/early/2016/11/03/13993003.01177-2016.short
4100  - http://erj.ersjournals.com/content/early/2016/11/03/13993003.01177-2016.full
AB  - The efficacy of adenotonsillectomy for treating obstructive sleep apnoea syndrome (OSAS) in children has been established, but its precise effects on inspiratory effort are not well documented.In 353 children enrolled in the Childhood Adenotonsillectomy Trial, randomised to undergo either early adenotonsillectomy (n=182) or a strategy of watchful waiting with supportive care (WWSC) (n=171), thoraco-abdominal asynchrony (TAA) was analysed during quiet, non-apnoeic and non-hypopnoeic breathing during sleep at baseline and at 7 months using overnight polysomnography.Children who underwent early adenotonsillectomy demonstrated a reduction in TAA post-surgery while the WWSC arm showed no change. On assessing TAA with regard to normalisation of clinical polysomnography findings at follow-up, TAA was reduced in children who had surgical resolution of OSAS (based on apnoea–hypopnoea index), but not in children who displayed spontaneous normalisation of apnoea–hypopnoea index. In the latter group, TAA was inversely correlated with quality of life.We conclude that adenotonsillectomy reduces TAA during quiet sleep. Monitoring of instantaneous TAA may yield additional insight in the dynamic changes of inspiratory effort. In combination with traditional indices of obstruction, TAA may more accurately characterise the degree of sleep-disordered breathing in children.Adenotonsillectomy for childhood obstructive sleep apnoea reduces respiratory effort during sleep http://ow.ly/TJcx304lKdm