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The Impacts of Obstructive Sleep Apnea Hypopnea Syndrome Severity and Surgery Intervention on Psychological and Behavioral Abnormalities and Postoperative Recovery in Pediatric Patients

Jin Zhu, Yu Fang, Xin Chen, Haifei Wang, Yaoshu Teng, Daojun Yu, Haisheng Zhang, Yi Shen

Department of Otorhinolaryngology Head and Neck Surgery, Hangzhou First People’s Hospital Affiliated to Nanjing Medical University, Hangzhou, China (mainland)

Med Sci Monit 2014; 20:1474-1480

DOI: 10.12659/MSM.890532

Available online:

Published: 2014-08-19

Background: The aim of this study was to investigate the degree of impact of obstructive sleep apnea hypopnea syndrome (OSAHS) severity on pediatric psychological and behavioral abnormalities.
Material and Methods: Fifty-one children aged 5–12 years with a confirmed diagnosis of OSAHS were divided into 3 groups according to the severity of OSAHS. They underwent bilateral tonsillectomy plus adenoidectomy or adenoidectomy alone. Repeated polysomnography and integrated visual and auditory continuous performance testing (­IVA-CPT) was performed to assess full-scale response control quotient (FRCQ), full-scale attention quotient (FAQ), and hyperactivity (HYP) before surgery and 3 and 6 months after surgery.
Results: Mean FRCQ, FAQ, and HYP significantly improved over time in the 3 groups (FRCQ, F=292.05; FAQ, F=258.27; HYP, F=295.10, all P<0.001). FRCQ and HYP were not significantly different among the groups at the 3 time points. FAQ was significantly different among the groups (F=3.89, P<0.05). For FRCQ, FAQ, and HYP, there was no interaction between time and disease severity. Within groups, the effect of time on the apnea-hypopnea index (AHI) and lowest oxygen saturation (LaSO2) were significant for each group and they were significantly different among the 3 groups at each time point (all P<0.001).
Conclusions: These results suggest that OSAHS may have a significant impact on self-control, attention, and hyperactivity in children, which is gradually alleviated after surgery. Disease severity was not closely related to preoperative mental and psychological function or postoperative recovery. Thus, we find it difficult to determine the impact degree of OSAHS severity on mental and psychological function or predict postoperative recovery by using OSAHS severity alone in children.

Keywords: Attention - physiology, Analysis of Variance, Adenoidectomy - psychology, Child, China, Executive Function - physiology, Motor Activity - physiology, Polysomnography, Sleep Apnea Syndromes - surgery, Tonsillectomy - psychology