A clinical trial has uncovered the benefits of surgical intervention for some children experiencing mild sleep-disordered breathing (SDB).
The study, conducted on children with snoring and slight breathing issues during sleep, discovered notable enhancements in their sleep patterns, quality of life and blood pressure one-year post-surgery.
The research was backed by the National Institutes of Health and was published in the Journal of the American Medical Association.
But Dr Susan Redline, the study’s lead from Brigham and Women’s Hospital and Harvard Medical School, suggests a cautious approach.
Monitoring children who solely snore without additional symptoms might be reasonable over time, while surgery could be a beneficial option for those facing disturbed sleep, daytime fatigue and behavioural difficulties.
SDB encompasses breathing disruptions during sleep, ranging from loud snoring to sleep apnea.
It affects around 6-17% of typically developing children in the US.
Left untreated, it can escalate the risk of behavioural issues, reduced quality of life and cardiovascular ailments like heart disease and high blood pressure.
Additionally, there’s growing interest in understanding how sleep disorders might impact brain development, cognition and academic performance.
Adenotonsillectomy is a standard treatment for moderate to severe SDB, aiming to alleviate snoring and enhance breathing. Yet, its efficacy for children with milder forms of SDB has remained uncertain.
The Paediatric Adenotonsillectomy Trial for Snoring (PATS) was a comprehensive study involving 459 children and adolescents with mild SDB, conducted across seven academic sleep centres in the US.
Spanning 2016 to 2021, the trial provided insights into the impacts of surgery versus supportive care without surgery, which included education on healthy sleep practices and lifestyle adjustments.
While both groups displayed cognitive and attention improvements, the surgery group exhibited several favourable changes.
These encompassed reduced daytime sleepiness, improved SDB, diminished snoring, fewer behavioural issues, enhanced quality of life, and lowered blood pressure. Additionally, the surgery seemed to impede the progression to full-blown sleep apnea in the treated children.
The study’s secondary outcomes spotlighted the benefits of surgery, although cognitive and attention improvements didn't significantly differ between the surgery and non-surgery groups.
Researchers intend to delve deeper into the long-term effects of surgery in this demographic and stress the necessity of refining screening tools to pinpoint better the children who would gain the most from adenotonsillectomy.
Dr Marishka Brown, the National Centre on Sleep Disorder’s Research director within the NHLBI, emphasises that while adenotonsillectomy proves helpful for some children with mild SDB, it might not be suitable for everyone.
