ADHD Clinical Trial
Official title:
Behavioral Effect of Obstructive Sleep Apnea in Children
Sleep-disordered breathing (SDB) in children may be responsible for disruptive daytime behaviors such as inattention and hyperactivity. Many children undergo tonsillectomy for SDB and disruptive daytime behaviors. However, the link between SDB and disruptive behavior is not clearly understood. This study will evaluate the relationship between SDB and disruptive behavior.
While adenotonsillectomy (AT) remains one of the most common surgical procedures performed
in children, indications for AT have changed in recent years. Surgeons now perform AT for
suspected obstructive SDB and for daytime behaviors that may be a consequence of SDB, such
as inattention and hyperactivity. However, whether SDB causes these and other disruptive
behaviors is not well known. Further, the precise nature of these behaviors and what types
or levels of SDB may be of concern are poorly understood. Consequently, pediatricians and
otolaryngologists are not able to use objective preoperative testing to assess SDB and
abnormal behavior.
This research project seeks to better define the relationship between childhood SDB and
daytime behavioral problems and to determine whether SDB actually causes these behaviors.
The study will better define whether inattention and hyperactivity are frequent among
children who undergo AT, will identify measures and levels of SDB that are indicative of
these behaviors, and will test whether improvement in SDB after AT is associated with
improvement in behavior.
Five- to twelve-year-old children who have been scheduled for AT or for a control group
procedure (minimally invasive, non-airway-related surgeries such as herniorraphies) will
undergo behavioral assessments, cognitive tests, and structured psychiatric interviews. A
secondary control group will include healthy children who are not scheduled for any type of
surgery. Preoperative assessments will be used to define what behaviors are more prominent
in the children scheduled for AT than in children scheduled for hernia repair. All children
will undergo preoperative polysomnography to detect subtle forms of SDB that may be
particularly prevalent in children. Children will also undergo assessments after surgery.
Children will be scheduled for two or three study visits, depending on whether participants
agreed to an optional 3-month interim assessment. Children will be followed for
approximately 1 year from the date of surgery.
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Observational Model: Cohort, Time Perspective: Prospective
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