Childhood Adenotonsillectomy Trial

5.1 Overall Project Goal

Untreated, pediatric obstructive sleep apnea syndrome (OSAS) is associated with a wide range of adverse health outcomes, which may lead to chronic health sequelae. A major component of OSAS morbidity relates to short, and possible, long-term neuropsychology (NP) deficits caused by exposure to intermittent hypoxemia, arousal, and sleep deprivation, acting independently or synergistically. Adenotonsillar enlargement is the most commonly recognized risk factor for OSAS in children. This project examines the hypothesis that Adenotonsillectomy (AT) in children aged 5 to 9 years will result in measurable improvements in health outcomes measured 6 months following AT. Children eligible for AT in standard practice will be randomized to expedited (early) adenotonsillectomy (EAT) versus Watchful Waiting with Supportive Care (WW) with surgical treatment decisions deferred until after a seven (7) month observation period, with continued follow-up through twelve (12) months. The cognitive and behavioral tests were chosen to emphasize measurements sensitive to sleepiness or intermittent hypoxemia, as well as providing reliable measures of overall cognitive ability, memory, language abilities, psychomotor skills, behavior, and mood.