Effect of adenotonsillectomy on central sleep apnea: A scoping review

Abstract

Objective: The purpose of this study was to assess the effects of adenotonsillectomy (A&T) on reducing central sleep apnea (CSA) in children and adolescents with obstructive sleep apnea (OSA).

Methods: A review of the PubMed database was conducted. Two researchers independently reviewed the articles from the literature search and selected papers for further review if they met inclusion criteria. Included studies were prospective studies and case series whose patients were children 18 years or younger undergoing adenotonsillectomy for obstructive sleep apnea with reported pre and postoperative central apnea indexes (CAI).

Results: Of the 107 articles initially identified, 18 underwent full length review, and ultimately 15 for final review. All studies reported marked improvement of central sleep apnea indexes after adenotonsillectomy. Two studies found resolution of CSA in 66.7 % and 73.7 % of patients respectively. The remaining four studies found significant reductions in CAI in 43.9 %-93 % of patients. The degree of reduction varied from 40.9 % to 80 %.

Discussion: Adenotonsillectomy improves and at times resolves CSA in pediatric patients with concomitant OSA.

Keywords: Adenotonsillectomy; Central sleep apnea; Obstructive sleep apnea; Pediatric sleep-disordered breathing; Pediatrics.