Adenotonsillectomy Reduces Obstructive Sleep Apnea and Improves Sleep Quality in Adult Patients.

Abstract

Background: Adenotonsillectomy is widely established as a first-line treatment for obstructive sleep apnea (OSA) in children; however, its effectiveness and clinical role in adult patients remain less well defined.

Purpose: The study purpose was to measure changes in sleep quality and OSA risk in adults following adenotonsillectomy.

Study design, setting, sample: This was a prospective cohort study conducted at Unimed, in Itaperuna, RJ, Brazil, including 28 adult patients diagnosed with OSA.

Predictor/exposure/independent variable: The primary predictor variable was the time point (preoperative vs 2 months postoperative).

Main outcome variables: The main outcome variable was therapeutic response, measured using sleep quality, OSA risk, and daytime fatigue.

Covariates: Age, sex, body mass index, and baseline sleep quality.

Analyses: Descriptive and inferential analyses were performed using χ², Fisher's exact, and Wilcoxon tests (P < .05).

Results: The sample included 28 subjects with a mean age of 28.4 years (±9.1), of whom 15 (53.6%) were male. Adenotonsillectomy improved sleep quality and reduced OSA risk. The proportion of subjects classified as high-risk for OSA decreased from 71.73 to 0% (P < .0001). Median Pittsburgh Sleep Quality Index scores improved from 9.5 (interquartile range 6 to 11) presurgery to 2.0 (1 to 4) postsurgery (P < .0001). In addition, daytime fatigue and snoring frequency also showed marked reductions postoperatively (P < .0001).

Conclusions and relevance: Among adults with significant tonsillar or adenoidal hypertrophy and OSA, adenotonsillectomy was associated with improvements in sleep quality and reduced OSA risk. It may represent a viable alternative for patients who cannot tolerate continuous positive airway pressure or present anatomical upper airway obstruction.