Trial reportSleep2021
Cyclic alternating pattern in children with obstructive sleep apnea and its relationship with adenotonsillectomy, behavior, cognition, and quality of life.
Trial report in Sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00560859 (A Randomized Controlled Study of Adenotonsillectomy for Children With Obstructive Sleep Apnea Syndrome), which is not on this map. Cited by 10 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Controlled Study of Adenotonsillectomy for Children With Obstructive Sleep Apnea Syndrome
Who cites it
10 citing papers in PubMed, 24 citations in OpenAlex.
- Association between psychotropic medication and sleep microstructure: evidence from large population studies.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Trial
- Disentangling baseline severity and residual disease from BMI effects after adenotonsillectomy.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Pediatric OSA-Spectrum of the Disease and Opportunities for Personalized Interventions.Journal of personalized medicine · 2026Review
- Differential effects of adenotonsillectomy on growth and asthma control in children with obstructive sleep apnea and varying body mass index: A prospective cohort study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- [Association Between Obstructive Sleep Apnea and Behavioral Problems in Children].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2025Article
- Sleep and circadian disturbances in children with neurodevelopmental disorders.Nature reviews. Neurology · 2025Review
- Sleep and Breathing Conference highlights 2023: a summary by ERS Assembly 4.Breathe (Sheffield, England) · 2023Article
- Neurobehavioral morbidity of pediatric mild sleep-disordered breathing and obstructive sleep apnea.Sleep · 2022Article
- Sleep Disturbances in Chinese Children with Epilepsy: Associations with Behavioral Problems and Quality of Life.Nature and science of sleep · 2022Article
- The Effect of Adenotonsillectomy on Children's Behavior and Cognitive Performance with Obstructive Sleep Apnea Syndrome: State of the Art.Children (Basel, Switzerland) · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
Abstract
STUDY
objectivesTo determine in children with obstructive sleep apnea (OSA) the effect of adenotonsillectomy (AT) on the cyclic alternating pattern (CAP) and the relationship between CAP and behavioral, cognitive, and quality-of-life measures.
methodsCAP parameters were analyzed in 365 overnight polysomnographic recordings of children with mild-to-moderate OSA enrolled in the Childhood Adenotonsillectomy Trial (CHAT), randomized to either early AT (eAT) or watchful waiting with supportive care (WWSC). We also analyzed CAP in a subgroup of 72 children with moderate OSA (apnea-hypopnea index > 10) that were part of the CHAT sample. Causal mediation analysis was performed to determine the independent effect of changes in CAP on selected outcome measures.
resultsAt baseline, a higher number of A1 phases per hour of sleep was significantly associated with worse behavioral functioning (caregiver Behavior Rating Inventory of Executive Function (BRIEF) Global Executive Composite (GEC): ρ = 0.24, p = 0.042; caregiver Conners' Rating Scale Global Index: ρ = 0.25, p = 0.036) and lower quality of life (OSA-18: ρ = 0.27, p = 0.022; PedsQL: ρ = -0.29, p = 0.015) in the subgroup of children with moderate OSA, but not across the entire sample. At 7-months follow-up, changes in CAP parameters were comparable between the eAT and WWSC arms. CAP changes did not account for significant proportions of variations in behavioral, cognitive, and quality-of-life performance measures at follow-up.
conclusionsWe show a significant association between the frequency of slow, high-amplitude waves with behavioral functioning, as well as the quality of life in children with moderate OSA. Early AT in children with mild-to-moderate OSA does not alter the microstructure of nonrapid eye movement sleep compared with watchful waiting after an approximately 7-month period of follow-up. CLINICAL TRIAL: The study "A Randomized Controlled Study of Adenotonsillectomy for Children With Obstructive Sleep Apnea Syndrome" was registered at Clinicaltrials.gov (#NCT00560859).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.