Predictors of sleep-disordered breathing in children with a history of tonsillectomy and/or adenoidectomy

Study Objectives: To identify predictors of sleep-disordered breathing (SDB ) in children who have undergone self-reported tonsillectomy and/or adenoid ectomy (TA). Design: Observational study of pediatric participants in a longitudinal gen etic-epidemiological cohort study of SDB Setting: Community-based; studies conducted at participants' homes Participants: 577 children age < 18 (10.8 +/-4.2 SD) years; 53% female; 48% Black; 76% with a family member identified with SDB Interventions: NA Measurements and Results: Medical history assessed by questionnaire. Physic al measures made directly. SDB was assessed with overnight in-home cardio-r espiratory monitoring. 10% of children (n=60) had had aTA 5.5 +/-4.6 yrs pr eviously, An Apnea-Hypopnea Index (AHI, events/hr) greater than or equal to 5 was found in a higher proportion of children with a reported TA than in c hildren with no history of out surgery (35% vs. 13.7%, p < 001). A TA was r eported more frequently for non-Blacks than for Blacks (13.6% non-Blacks, 6 .9% Blacks, p=.02). Among children who had a TA, significant predictors of SDB (AHI greater than or equal to5) were: Black ethnicity (SDB in 57% vs. 2 4% of Blacks vs. non-Blacks; adjusted odds ratio (OR): 3.85; 95% Cl: 1.11, 13.33) and obesity (OR 3.98; 95% Cl: 1.05, 15.08). SDB also tended to be gr eater in children with a family member with SDB (OR 2.87; 95% Cl: 0.65, 12. 07). Conclusions: Black children were less likely to have undergone TA but more likely to have SDB after TA surgery. These findings underscore the need to follow children post-TA and for evidence-based studies that define the role of TA in the management of pediatric adenotonsillar disease.