The most common treatment used to help those with Obstructive Sleep Apnea (OSA) is supportive therapy during sleep with a CPAP (continuous positive air pressure) machine. While this treatment can be very effective at treating the condition and alleviating the symptoms, it can be difficult to get those with the condition to use the machines, especially with children who have sleep apnea. But the short and long term effects of sleep apnea can be severe which means it is imperative the additional treatment options are developed, tested, and put to use.
A study conducted earlier this year was part of the effort to seek alternative options for long term management of sleep apnea in children. The project, called The Childhood Adenotonsillectomy Trial (CHAT), involved a team of researchers from different medical facilities. The results of the study were published in the New England Journal of Medicine and were presented at the annual meeting of the American Thoracic Society this year.
The CHAT study looked at 464 children between the ages of 5 and 9 who had been diagnosed with sleep apnea. The purpose of the study was to determine if Adenotonsillectomy (AT), a common surgery used to treat sleep apnea in children, produced more beneficial outcomes than those outcomes achieved with supportive therapies like CPAP.
The participants were randomly assigned to one of two groups. The first group underwent the AT surgery. The second group received supportive care. Each participant underwent a sleep study at an outpatient sleep center at the beginning of the study and then again seven months after surgery or the start of treatment.
Children with sleep apnea can experience a variety of problems that affect their overall quality of life and their ability to learn and thrive in school. These problems can include behavioral issues, activity level, problems with attention, and executive functioning. In order to gauge whether or not the outcomes of surgical intervention were more beneficial than those achieved with supportive therapy, additional data about each participant was collected.
To determine if there were differences in attention span and executive functioning, each participant was given a formal neuropsychological test called the Developmental Neuropsychological Assessment. The data from this assessment was the primary output of the study. Analysis of these data indicated that there was no difference in the attention level or executive function of those children who underwent the surgery when compared to those who received supportive therapy.
In addition to the formal assessment, data was also collected for each participant by having parents and teachers complete questionnaires rating the participating child’s sleepiness, behavior, and quality of life. These results indicate that children who have the surgery, which removes their adenoids and tonsils, experience noteworthy improvements in their behavior and overall quality of life when compared with the results of those participating children who did not have surgery.
The survey indicates that while there may be some benefits to having the surgery, there isn’t an overwhelming reason to choose surgery over supportive care which can help parents make the best decision for their children.