PEDIATRICS Vol. 117 No. 2 February 2006, pp. e200-e208 (doi:10.1542/peds.2005-1007)
Increases in Overweight After Adenotonsillectomy in Overweight Children With Obstructive Sleep-Disordered Breathing Are Associated With Decreases in Motor Activity and Hyperactivity
a Department of Pediatrics, School of Medicine and Biomedical Sciences University at Buffalo, Buffalo, New York
b Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
c Department of Pediatrics University of Virginia School of Medicine, Charlottesville, Virginia
d Department of Internal Medicine, Pulmonary and Critical Care Division, Sleep Disorders Center, University of Virginia School of Medicine, Charlottesville, Virginia
e Departments of Psychiatry and Human Behavior, Brown Medical School, Brown University, Providence, Rhode Island
Objective. To examine the effect of adenotonsillectomy (T&A) in children with obstructive sleep-disordered breathing on growth, hyperactivity, and sleep and waking motor activity.
Methods. We studied 54 children who were aged 6 to 12 years and had adenotonsillar hypertrophy and an obstructive apnea-hypopnea index of 
1 before and 12 months after they all received adenotonsillectomy (T&A). We measured their height, weight, percentage overweight (patient BMI – BMI at 50th percentile)/BMI at 50th percentile * 100) and obtained a hyperactivity score from parent report on a standardized behavior questionnaire scale. A subset of 21 of these children were also studied for motor activity by wrist actigraphy for 7 consecutive days and nights before and 12 months after T&A.
Results. After T&A, mean obstructive apnea-hypopnea index decreased from 7.6 to 0.6. Height percentile did not change, but weight percentile increased; as a consequence, percentage overweight increased from 32.0% to 36.3%. Hyperactivity scores and total daily motor activity were reduced after T&A. From linear regression, the reduction in hyperactivity scores predicted an increase in percentage overweight. Reduced motor activity was correlated with increased percentage overweight.
Conclusions. An increase in percentage overweight after T&A in children with obstructive sleep-disordered breathing is correlated to decreased child hyperactivity scores and to decreased measured motor activity in the subset studied. These associations suggest that the increase in overweight may be attributable to reductions in physical activity and fidgeting energy expenditure.
Key Words: sleep apnea • growth • height • weight • obesity • physical activity • hyperactivity • nonexercise activity thermogenesis
Abbreviations: OSDB—obstructive sleep-disordered breathing • T&A—adenotonsillectomy • OAHI—obstructive apnea-hypopnea index
Accepted Aug 5, 2005.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  S. L. Verhulst, J. De Backer, L. Van Gaal, W. De Backer, and K. Desager Adenotonsillectomy as First-Line Treatment for Sleep-disordered Breathing in Obese Children Am. J. Respir. Crit. Care Med., June 15, 2008; 177(12): 1399 - 1399. [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Owens, R. Mehlenbeck, J. Lee, and M. M. King Effect of Weight, Sleep Duration, and Comorbid Sleep Disorders on Behavioral Outcomes in Children With Sleep-Disordered Breathing Arch Pediatr Adolesc Med, April 1, 2008; 162(4): 313 - 321. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. S. Capdevila, L. Kheirandish-Gozal, E. Dayyat, and D. Gozal Pediatric Obstructive Sleep Apnea: Complications, Management, and Long-term Outcomes Proceedings of the ATS, February 15, 2008; 5(2): 274 - 282. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L Verhulst, N. Schrauwen, D. Haentjens, B. Suys, R. P Rooman, L. Van Gaal, W. A De Backer, and K. N Desager Sleep-disordered breathing in overweight and obese children and adolescents: prevalence, characteristics and the role of fat distribution Arch. Dis. Child., March 1, 2007; 92(3): 205 - 208. [Abstract] [Full Text] [PDF]
|
|
