Measuring sleep quality after adenotonsillectomy in pediatric sleep apnea

Seung Hoon Lee, Ji Ho Choi, Il Ho Park, Sang Hag Lee, Tae Hoon Kim, Heung Man Lee, Hee Kwon Park, Robert J. Thomas, Chol Shin, Chang Ho Yun

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)


Objectives/Hypothesis: The aim of this study was to demonstrate postoperative changes in sleep quality in children with obstructive sleep apnea (OSA), using both conventional sleep staging and electrocardiogram-based cardiopulmonary coupling (CPC) analysis. The hypothesis is that being electroencephalography (EEG)-independent, CPC may detect changes in sleep quality that traditional sleep architecture analysis cannot. Study Design: Retrospective outcome research. Methods: We included 37 children (aged 6.89 ± 2.76 years, 28 male) with OSA who underwent adenotonsillectomy, and analyzed standard polysomnography and CPC parameters from a full-night study before and after adenotonsillectomy. High-frequency coupling (HFC) and low-frequency coupling (LFC) were used as indices of stable and unstable sleep, respectively. Results: Adenotonsillectomy led to a significant change in CPC parameters (HFC, 50.3 ± 16.1% to 56.1 ± 14.7%, P =.03; LFC, 35.1 ± 14.5% to 27.3 ± 13.0%, P =.003), which was paralleled by improvements in the apnea-hypopnea (12.7 ± 13.7 to 1.0 ± 0.8, P <.001) and arousal index (20.8 ± 11.5 to 9.9 ± 3.9, P <.001). Polysomnographic sleep stage parameters other than the arousal index did not reflect postoperative resolution of OSA. Conclusions: In pediatric OSA, postoperative improvement of sleep quality is more readily discernible by CPC analysis than EEG-based sleep staging. The CPC analysis may have potential advantages in the assessment of sleep quality in pediatric populations.

Original languageEnglish
Pages (from-to)2115-2121
Number of pages7
Issue number9
Publication statusPublished - 2012 Sept


  • Child
  • adenotonsillectomy
  • electrocardiogram
  • electroencephalogram
  • obstructive sleep apnea
  • sleep quality

ASJC Scopus subject areas

  • Otorhinolaryngology


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