Sleep Studies in Children Can Prevent Unnecessary Surgery

Recent study suggests that healthy children who have sleep-disordered breathing symptoms (snoring or temporary cessation of breathing) should consider undergoing polysomnography (sleep study) before surgery.

After undergoing the polysomnography, parents should then discuss the potential benefits of this with their doctor (pediatrician or otolaryngologist) to manage the child's symptoms medically before surgery.

Sleep-disordered breathing can range from mild snoring to severe sleep apnea, and doing a sleep study will give more information on the severity of the condition.

Doctors often suggest an adenotonsillectomy (removal of both the adenoids and tonsils) to improve the condition. However, there are conflicting guidelines on the potential benefits of sleep studies.

The study aimed to determine the prevalence and characteristics of children with normal elective sleep studies for obstructive sleep disordered breathing. To do this, a retrospective study was done on patients aged two to 18 years who underwent diagnostic polysomnography for sleep-disordered breathing from 2012 to 2018.

Michael Cohen, corresponding author, explained that many children (44.7%) had normal sleep studies who would proceed to surgery without a pre-operative sleep study if the guidelines were followed, and the need for surgery was questionable.

Findings also showed that Caucasian children, children without respiratory symptoms other than snoring, children older than four years old, and children with smaller tonsils, were more likely to have normal sleep studies.

Jessica Levi, co-author, believes this research shows that sleep studies can affect managerial decisions on whether to proceed with an adenotonsillectomy or to medically manage the child's symptoms.

"The potential delays in care and cost associated with obtaining polysomnography should be weighed against parental concerns and the possibility that the outcome could change management. These factors should be discussed with the family of each patient with a goal of shared decision-making," adds Levi.

‘Many children (44.7%) had normal sleep studies who would proceed to surgery without a pre-operative sleep study if the guidelines were followed, and the need for surgery was questionable.’

Source: Medindia