Effect of adenotonsillectomy on parent-reported sleepiness in children with obstructive sleep apnea

Shalini Paruthi, Paula Buchanan, Jia Weng, Ronald D. Chervin, Ronald B. Mitchell, Dawn Dore-Stites, Anjali Sadhwani, Eliot S. Katz, John Bent, Carol L. Rosen, Susan Redline, Carole L. Marcus

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Study Objectives: To describe parental reports of sleepiness and sleep duration in children with polysomnography (PSG)-confirmed obstructive sleep apnea (OSA) randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC) in the ChildHood Adenotonsillectomy Trial (CHAT). We hypothesized children with OSA would have a larger improvement in sleepiness 6 mo following eAT compared to WWSC. Methods: Parents of children aged 5.0-9.9 y completed the Epworth Sleepiness Scale modified for children (mESS) and the Pediatric Sleep Questionnaire- Sleepiness Subscale (PSQ-SS). PSG was performed at baseline and at 7-mo endpoint. Children underwent early adenotonsillectomy or WWSC. Results: The mESS and PSQ-SS classified 24% and 53% of the sample as excessively sleepy, respectively. At baseline, mean mESS score was 7.4 ± 5.0 (SD) and mean PSQ-SS score was 0.44 ± 0.30. Sleepiness scores were higher in African American children; children with shorter sleep duration; older children; and overweight children. At endpoint, mean mESS score decreased by 2.0 ± 4.2 in the eAT group versus 0.3 ± 4.0 in the WWSC group (P < 0.0001); mean PSQ-SS score decreased 0.29 ± 0.40 in eAT versus 0.08 ± 0.40 in the WWSC group (P < 0.0001). Despite higher baseline sleepiness, African American children experienced similar improvement with adenotonsillectomy than other children. Improvement in sleepiness was weakly associated with improved apnea-hypopnea index or oxygen desaturation indices, but not with change in other polysomnographic measures. Conclusions: Sleepiness assessed by parent report was prevalent; improved more after eAT than after WWSC; and was not strongly predicted by sleep disturbances identified by PSG. Clinical Trial Registration: Childhood Adenotonsillectomy Study for Children with OSA (CHAT). ClinicalTrials.gov Identifier #NCT00560859.

Original languageEnglish (US)
Pages (from-to)2005-2012
Number of pages8
Issue number11
StatePublished - Nov 1 2016


  • Adenotonsillectomy
  • Apnea-hypopnea index
  • Epworth Sleepiness Scale
  • OSA
  • OSAS
  • Pediatric
  • Pediatric Sleep Questionnaire
  • Polysomnogram
  • Sleepiness

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)


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