Behavioral Effects of Obstructive Sleep Apnea in Children
Condition: Sleep-disordered Breathing; Sleep Apnea, Obstructive; ADHD
MeSH terms: Apnea; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Respiratory Aspiration
Study type: Observational

Summary: 
      Sleep-disordered breathing (SDB) in children may be responsible for disruptive daytime
      behaviors such as inattention and hyperactivity. Many children undergo tonsillectomy for SDB
      and disruptive daytime behaviors. However, the link between SDB and disruptive behavior is
      not clearly understood. This study will evaluate the relationship between SDB and disruptive
      behavior.
    

Detailed description: 
      While adenotonsillectomy (AT) remains one of the most common surgical procedures performed in
      children, indications for AT have changed in recent years. Surgeons now perform AT for
      suspected obstructive SDB and for daytime behaviors that may be a consequence of SDB, such as
      inattention and hyperactivity. However, whether SDB causes these and other disruptive
      behaviors is not well known. Further, the precise nature of these behaviors and what types or
      levels of SDB may be of concern are poorly understood. Consequently, pediatricians and
      otolaryngologists are not able to use objective preoperative testing to assess SDB and
      abnormal behavior.

      This research project seeks to better define the relationship between childhood SDB and
      daytime behavioral problems and to determine whether SDB actually causes these behaviors. The
      study will better define whether inattention and hyperactivity are frequent among children
      who undergo AT, will identify measures and levels of SDB that are indicative of these
      behaviors, and will test whether improvement in SDB after AT is associated with improvement
      in behavior.

      Five- to twelve-year-old children who have been scheduled for AT or for a control group
      procedure (minimally invasive, non-airway-related surgeries such as herniorraphies) will
      undergo behavioral assessments, cognitive tests, and structured psychiatric interviews. A
      secondary control group will include healthy children who are not scheduled for any type of
      surgery. Preoperative assessments will be used to define what behaviors are more prominent in
      the children scheduled for AT than in children scheduled for hernia repair. All children will
      undergo preoperative polysomnography to detect subtle forms of SDB that may be particularly
      prevalent in children. Children will also undergo assessments after surgery.

      Children will be scheduled for two or three study visits, depending on whether participants
      agreed to an optional 3-month interim assessment. Children will be followed for approximately
      1 year from the date of surgery.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Pediatric Otolaryngology surgery practices and primary care or general surgery practices at
        University of Michigan and St. Joseph Mercy Health Systems
      
Keywords: Polysomnography; Sleep-disordered breathing; Sleep apnea, obstructive; Hyperactivity; Sleep; Child