Some research studies have demonstrated an association between obstructive sleep apnea (OSA) and asthma. It's not clear why they are linked - it could be that both involve inflammation. OSA is also associated with obesity, which is linked to asthma. The most common treatment for OSA in children is the surgical removal of adenoids and tonsils, referred to as an adenotonsillectomy (AT). This study looked at historical medical and pharmacy records of children with asthma who did and did not have AT. The data in this study was from quite a large database, and the children who had AT were matched with those without AT.
The results showed that asthma flare-ups were worse in children the year prior to AT. However, after AT, asthma flare-ups declined significantly, to levels similar to the kids with asthma who did not receive AT. A similar decrease was seen in asthma medication refills in those children who underwent AT.
The study authors conclude that the presence of OSA can worsen asthma control in children, and that treatment of the OSA with AT may reduce asthma flare-ups. The authors appropriately caution that prospective studies will be needed to establish a causal relationship.
Showing posts with label adenotonsillectomy. Show all posts
Showing posts with label adenotonsillectomy. Show all posts
Wednesday, November 26, 2014
Wednesday, August 13, 2014
Weight gain after tonsil removal for obstructive sleep apnea
Children with obstructive sleep apnea (OSA) can have reduced growth rates. The primary treatment of OSA in children is removing the tonsils adenoids, referred to as an adenotonsillectomy. After this procedure, studies have shown an increase in weight. However, some kids that are overweight before adenotonsillectomy put on even more weight after the surgery.
This study looked at two groups of children, ages 5-10 years old, who had OSA. One group got adenotonsillectomy and the other group received no treatment - just watchful waiting. Sleep studies and height / weight measurements were repeated 7 months later. Results showed that body weight and body mass index (BMI) increased in both groups of patients. This may be because the sleep apnea severity improved in both groups. It's unclear why that happened, especially with the weight gain. I would think that would make the sleep apnea severity worse in the untreated group.
What was remarkable about the study, however, was that after adjusting for baseline weight and other variables, the weight gain experienced by those that had the adenotonsillectomy was significantly greater than the group that received no treatment. In those children who were already overweight at the start of the study, 52% became obese after adenotonsillectomy vs 21% in the group that did not receive treatment. The researchers proposed several mechanisms for weight gain after adenotonsillectomy: increased calories consumed, unhealthy food choices, decreased energy burned due to reduced work of breathing, improvement in blood oxygen levels, and increased growth hormone secretion.
The authors recommend monitoring weight, nutritional counseling, and encouragement of physical activity after adenotonsillectomy for OSA in children.
This study looked at two groups of children, ages 5-10 years old, who had OSA. One group got adenotonsillectomy and the other group received no treatment - just watchful waiting. Sleep studies and height / weight measurements were repeated 7 months later. Results showed that body weight and body mass index (BMI) increased in both groups of patients. This may be because the sleep apnea severity improved in both groups. It's unclear why that happened, especially with the weight gain. I would think that would make the sleep apnea severity worse in the untreated group.
What was remarkable about the study, however, was that after adjusting for baseline weight and other variables, the weight gain experienced by those that had the adenotonsillectomy was significantly greater than the group that received no treatment. In those children who were already overweight at the start of the study, 52% became obese after adenotonsillectomy vs 21% in the group that did not receive treatment. The researchers proposed several mechanisms for weight gain after adenotonsillectomy: increased calories consumed, unhealthy food choices, decreased energy burned due to reduced work of breathing, improvement in blood oxygen levels, and increased growth hormone secretion.
The authors recommend monitoring weight, nutritional counseling, and encouragement of physical activity after adenotonsillectomy for OSA in children.
Friday, October 26, 2012
Removing tonsils and adenoids improves obstructive sleep apnea and bed-wetting
This article discusses research showing that removing tonsils and adenoids in children can resolve obstructive sleep apnea (OSA) and bed-wetting.
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