Depressive symptomatology in school-aged children with obstructive sleep apnea syndrome

incidence, demographic factors, and changes following a randomized controlled trial of adenotonsillectomy

Elise Hodges, Carole L. Marcus, Ji Young Kim, Melissa Xanthopoulos, Justine Shults, Bruno Giordani, Dean W. Beebe, Carol L. Rosen, Ronald D. Chervin, Ron B Mitchell, Eliot S. Katz, David Gozal, Susan Redline, Lisa Elden, Raanan Arens, Renee Moore, H. Gerry Taylor, Jerilynn Radcliffe, Nina H. Thomas

Research output: Contribution to journalArticle

Abstract

Study Objectives: Depressive symptoms following adenotonsillectomy (AT) relative to controls were examined in children with obstructive sleep apnea syndrome (OSAS). Methods: The Childhood Adenotonsillectomy Trial (CHAT) multisite study examined the impact of AT in 453 children aged 5 to 9.9 years with polysomnographic evidence of OSAS without prolonged desaturation, randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC). One hundred seventy-six children (eAT n = 83; WWSC n = 93) with complete evaluations for depressive symptomatology between baseline and after a 7-month intervention period were included in this secondary analysis. Results: Exact binomial test assessed proportion of depressive symptomatology relative to norms, while effects of AT and OSAS resolution were assessed through linear quantile mixed-models. Treatment group assignment did not significantly impact depression symptoms, although self-reported depression symptoms improved over time (p < 0.001). Resolution of OSAS symptoms demonstrated a small interaction effect in an unexpected direction, with more improvement in parent ratings of anxious/depressed symptoms for children without resolution (p = 0.030). Black children reported more severe depressive symptoms (p = 0.026) and parents of overweight/obese children reported more withdrawn/depressed symptoms (p = 0.004). Desaturation nadir during sleep was associated with self-report depressed (r = -0.17, p = 0.028), parent-reported anxious/depressed (r = -0.15, p = 0.049), and withdrawn/depressed (r = -0.24, p = 0.002) symptoms. Conclusions: Increased risk for depressed and withdrawn/depressed symptoms was detected among children with OSAS, and different demographic variables contributed to risk in self-reported and parent-reported depression symptoms. Arterial oxygen desaturation nadir during sleep was strongly associated with depressed symptoms. However, despite improvements in child-reported depressed symptoms over time, changes were unrelated to either treatment group or OSAS resolution status. Trials Registration: Childhood Adenotonsillectomy Study for Children with OSAS (CHAT), https://clinicaltrials.gov/show/NCT00560859, NCT00560859.

Original languageEnglish (US)
JournalSleep
Volume41
Issue number12
DOIs
StatePublished - Dec 1 2018

Fingerprint

Obstructive Sleep Apnea
Randomized Controlled Trials
Demography
Incidence
Depression
Sleep
Watchful Waiting
Self Report
Parents
Oxygen
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)

Cite this

Depressive symptomatology in school-aged children with obstructive sleep apnea syndrome : incidence, demographic factors, and changes following a randomized controlled trial of adenotonsillectomy. / Hodges, Elise; Marcus, Carole L.; Kim, Ji Young; Xanthopoulos, Melissa; Shults, Justine; Giordani, Bruno; Beebe, Dean W.; Rosen, Carol L.; Chervin, Ronald D.; Mitchell, Ron B; Katz, Eliot S.; Gozal, David; Redline, Susan; Elden, Lisa; Arens, Raanan; Moore, Renee; Taylor, H. Gerry; Radcliffe, Jerilynn; Thomas, Nina H.

In: Sleep, Vol. 41, No. 12, 01.12.2018.

Research output: Contribution to journalArticle

Hodges, E, Marcus, CL, Kim, JY, Xanthopoulos, M, Shults, J, Giordani, B, Beebe, DW, Rosen, CL, Chervin, RD, Mitchell, RB, Katz, ES, Gozal, D, Redline, S, Elden, L, Arens, R, Moore, R, Taylor, HG, Radcliffe, J & Thomas, NH 2018, 'Depressive symptomatology in school-aged children with obstructive sleep apnea syndrome: incidence, demographic factors, and changes following a randomized controlled trial of adenotonsillectomy', Sleep, vol. 41, no. 12. https://doi.org/10.1093/sleep/zsy180
Hodges, Elise ; Marcus, Carole L. ; Kim, Ji Young ; Xanthopoulos, Melissa ; Shults, Justine ; Giordani, Bruno ; Beebe, Dean W. ; Rosen, Carol L. ; Chervin, Ronald D. ; Mitchell, Ron B ; Katz, Eliot S. ; Gozal, David ; Redline, Susan ; Elden, Lisa ; Arens, Raanan ; Moore, Renee ; Taylor, H. Gerry ; Radcliffe, Jerilynn ; Thomas, Nina H. / Depressive symptomatology in school-aged children with obstructive sleep apnea syndrome : incidence, demographic factors, and changes following a randomized controlled trial of adenotonsillectomy. In: Sleep. 2018 ; Vol. 41, No. 12.
@article{fc941a8f748d4f15b5a53bc81c2317be,
title = "Depressive symptomatology in school-aged children with obstructive sleep apnea syndrome: incidence, demographic factors, and changes following a randomized controlled trial of adenotonsillectomy",
abstract = "Study Objectives: Depressive symptoms following adenotonsillectomy (AT) relative to controls were examined in children with obstructive sleep apnea syndrome (OSAS). Methods: The Childhood Adenotonsillectomy Trial (CHAT) multisite study examined the impact of AT in 453 children aged 5 to 9.9 years with polysomnographic evidence of OSAS without prolonged desaturation, randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC). One hundred seventy-six children (eAT n = 83; WWSC n = 93) with complete evaluations for depressive symptomatology between baseline and after a 7-month intervention period were included in this secondary analysis. Results: Exact binomial test assessed proportion of depressive symptomatology relative to norms, while effects of AT and OSAS resolution were assessed through linear quantile mixed-models. Treatment group assignment did not significantly impact depression symptoms, although self-reported depression symptoms improved over time (p < 0.001). Resolution of OSAS symptoms demonstrated a small interaction effect in an unexpected direction, with more improvement in parent ratings of anxious/depressed symptoms for children without resolution (p = 0.030). Black children reported more severe depressive symptoms (p = 0.026) and parents of overweight/obese children reported more withdrawn/depressed symptoms (p = 0.004). Desaturation nadir during sleep was associated with self-report depressed (r = -0.17, p = 0.028), parent-reported anxious/depressed (r = -0.15, p = 0.049), and withdrawn/depressed (r = -0.24, p = 0.002) symptoms. Conclusions: Increased risk for depressed and withdrawn/depressed symptoms was detected among children with OSAS, and different demographic variables contributed to risk in self-reported and parent-reported depression symptoms. Arterial oxygen desaturation nadir during sleep was strongly associated with depressed symptoms. However, despite improvements in child-reported depressed symptoms over time, changes were unrelated to either treatment group or OSAS resolution status. Trials Registration: Childhood Adenotonsillectomy Study for Children with OSAS (CHAT), https://clinicaltrials.gov/show/NCT00560859, NCT00560859.",
author = "Elise Hodges and Marcus, {Carole L.} and Kim, {Ji Young} and Melissa Xanthopoulos and Justine Shults and Bruno Giordani and Beebe, {Dean W.} and Rosen, {Carol L.} and Chervin, {Ronald D.} and Mitchell, {Ron B} and Katz, {Eliot S.} and David Gozal and Susan Redline and Lisa Elden and Raanan Arens and Renee Moore and Taylor, {H. Gerry} and Jerilynn Radcliffe and Thomas, {Nina H.}",
year = "2018",
month = "12",
day = "1",
doi = "10.1093/sleep/zsy180",
language = "English (US)",
volume = "41",
journal = "Sleep",
issn = "0161-8105",
publisher = "American Academy of Sleep Medicine",
number = "12",

}

TY - JOUR

T1 - Depressive symptomatology in school-aged children with obstructive sleep apnea syndrome

T2 - incidence, demographic factors, and changes following a randomized controlled trial of adenotonsillectomy

AU - Hodges, Elise

AU - Marcus, Carole L.

AU - Kim, Ji Young

AU - Xanthopoulos, Melissa

AU - Shults, Justine

AU - Giordani, Bruno

AU - Beebe, Dean W.

AU - Rosen, Carol L.

AU - Chervin, Ronald D.

AU - Mitchell, Ron B

AU - Katz, Eliot S.

AU - Gozal, David

AU - Redline, Susan

AU - Elden, Lisa

AU - Arens, Raanan

AU - Moore, Renee

AU - Taylor, H. Gerry

AU - Radcliffe, Jerilynn

AU - Thomas, Nina H.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Study Objectives: Depressive symptoms following adenotonsillectomy (AT) relative to controls were examined in children with obstructive sleep apnea syndrome (OSAS). Methods: The Childhood Adenotonsillectomy Trial (CHAT) multisite study examined the impact of AT in 453 children aged 5 to 9.9 years with polysomnographic evidence of OSAS without prolonged desaturation, randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC). One hundred seventy-six children (eAT n = 83; WWSC n = 93) with complete evaluations for depressive symptomatology between baseline and after a 7-month intervention period were included in this secondary analysis. Results: Exact binomial test assessed proportion of depressive symptomatology relative to norms, while effects of AT and OSAS resolution were assessed through linear quantile mixed-models. Treatment group assignment did not significantly impact depression symptoms, although self-reported depression symptoms improved over time (p < 0.001). Resolution of OSAS symptoms demonstrated a small interaction effect in an unexpected direction, with more improvement in parent ratings of anxious/depressed symptoms for children without resolution (p = 0.030). Black children reported more severe depressive symptoms (p = 0.026) and parents of overweight/obese children reported more withdrawn/depressed symptoms (p = 0.004). Desaturation nadir during sleep was associated with self-report depressed (r = -0.17, p = 0.028), parent-reported anxious/depressed (r = -0.15, p = 0.049), and withdrawn/depressed (r = -0.24, p = 0.002) symptoms. Conclusions: Increased risk for depressed and withdrawn/depressed symptoms was detected among children with OSAS, and different demographic variables contributed to risk in self-reported and parent-reported depression symptoms. Arterial oxygen desaturation nadir during sleep was strongly associated with depressed symptoms. However, despite improvements in child-reported depressed symptoms over time, changes were unrelated to either treatment group or OSAS resolution status. Trials Registration: Childhood Adenotonsillectomy Study for Children with OSAS (CHAT), https://clinicaltrials.gov/show/NCT00560859, NCT00560859.

AB - Study Objectives: Depressive symptoms following adenotonsillectomy (AT) relative to controls were examined in children with obstructive sleep apnea syndrome (OSAS). Methods: The Childhood Adenotonsillectomy Trial (CHAT) multisite study examined the impact of AT in 453 children aged 5 to 9.9 years with polysomnographic evidence of OSAS without prolonged desaturation, randomized to early adenotonsillectomy (eAT) or watchful waiting with supportive care (WWSC). One hundred seventy-six children (eAT n = 83; WWSC n = 93) with complete evaluations for depressive symptomatology between baseline and after a 7-month intervention period were included in this secondary analysis. Results: Exact binomial test assessed proportion of depressive symptomatology relative to norms, while effects of AT and OSAS resolution were assessed through linear quantile mixed-models. Treatment group assignment did not significantly impact depression symptoms, although self-reported depression symptoms improved over time (p < 0.001). Resolution of OSAS symptoms demonstrated a small interaction effect in an unexpected direction, with more improvement in parent ratings of anxious/depressed symptoms for children without resolution (p = 0.030). Black children reported more severe depressive symptoms (p = 0.026) and parents of overweight/obese children reported more withdrawn/depressed symptoms (p = 0.004). Desaturation nadir during sleep was associated with self-report depressed (r = -0.17, p = 0.028), parent-reported anxious/depressed (r = -0.15, p = 0.049), and withdrawn/depressed (r = -0.24, p = 0.002) symptoms. Conclusions: Increased risk for depressed and withdrawn/depressed symptoms was detected among children with OSAS, and different demographic variables contributed to risk in self-reported and parent-reported depression symptoms. Arterial oxygen desaturation nadir during sleep was strongly associated with depressed symptoms. However, despite improvements in child-reported depressed symptoms over time, changes were unrelated to either treatment group or OSAS resolution status. Trials Registration: Childhood Adenotonsillectomy Study for Children with OSAS (CHAT), https://clinicaltrials.gov/show/NCT00560859, NCT00560859.

UR - http://www.scopus.com/inward/record.url?scp=85058568281&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058568281&partnerID=8YFLogxK

U2 - 10.1093/sleep/zsy180

DO - 10.1093/sleep/zsy180

M3 - Article

VL - 41

JO - Sleep

JF - Sleep

SN - 0161-8105

IS - 12

ER -