Drug-Induced Sleep Endoscopy Directed Surgery Improves Polysomnography Measures In Overweight And Obese Children With Obstructive Sleep Apnea

BackgroundObstructive sleep apnea affects approximately 1-4% of all children, with increased prevalence amongst overweight and obese children.ObjectiveTo assess the effects of drug-induced sleep endoscopy (DISE)-directed surgery on polysomnography parameters in obese and overweight children.Material/MethodsA retrospective case-series was performed on obese and overweight pediatric patients who underwent clinically indicated DISE-directed surgery. Forty children met the inclusion criteria, including: body mass index >= 85%, DISE-study, and pre- and post-DISE polysomnography. Patients were divided into surgically naive (n = 23) and prior adenotonsillectomy (n = 17) groups. Demographic and clinical characteristics were examined with chi-square and Wilcoxon rank-sum test. Polysomnography parameters were compared with Wilcoxon signed rank test.ResultsOf 40 children with mean BMI 94% and mean age 8 +/- 6 years old, 17 (43%) underwent a previous adenotonsillectomy. Overall, significant improvements were observed in the apnea-hypopnea index (AHI; 25.0 to 9.9 events/hour, p < .01) and oxygen nadir (82.7% to 88.5%, p < .01). A similar pattern was observed among the surgically naive (AHI: 35.9 to 12.7 events/hour, p = .04; oxygen nadir: 79.7% to 86.4%, p = .2) and post-adenotonsillectomy groups (AHI: 10.4 to 6.2 events/hour, p = .02; oxygen nadir: 86.7% to 91.2%, p < .01).Conclusions/SignificancePolysomnography parameters significantly improved following DISE-directed interventions in obese and overweight children with obstructive sleep apnea.