Table 3.
Studies on impact of treatment of SDB and asthma
| Author (year) | Country | N | Male | Mean age (years) | Asthma diagnosis | SDB diagnosis | Type of study | Main results |
|---|---|---|---|---|---|---|---|---|
| Bhattacharjee et al (2010)9 | USA | 578 | 355 | 6.9 | History | PSG | Retrospective study: 578 children with OSA undergoing AT studied with PSG preoperatively and postoperatively | AT resulted in a significant AHI reduction from 18.2±21.4 to 4.1±6.4/hour total sleep time. 27.2% had complete resolution of OSA; asthma was a modest contributing factor for post-AT AHI |
| Bhattacharjee et al (2014)38 | USA | 40,518 | 22,320 | 7.7 | ICD-9-CM | ICD-9-CM | Retrospective study: 13,506 children with asthma with AT compared to 27,012 matched children with asthma without AT | AT associated with reductions in AAE (30.2%), ASA (37.9%), ARERs (25.6%), ARHs (35.8%), bronchodilators (16.7%), inhaled corticosteroids (21.5%), leukotriene receptor antagonists (13.4%), and systemic corticosteroids (23.7%) |
| Busino et al (2010)39 | USA | 465 | 263 | 5.9 | Clinical history | Previous diagnosis | Retrospective study: 465 children with AT, 16.6% asthmatics | AT associated with reductions of asthma therapies (eg, corticosteroids) and improvements in ACT scores |
| Kheirandish-Gozal et al (2011)40 | USA | 92 | 49 | 6.6 | Clinical history | PSG AHI >5/hour TST | Prospective study: 92 children with poorly controlled asthma, 63% with OSA and AT | AT associated with reduction in AAE (4.1±1.3 to 1.8±1.4/year), β-agonist rescue use (4.3±1.8 to 2.1±1.5/week), and ACT scores (3.1±1.9 to 1.9±1.7) |
| Levin et al (2014)42 | USA | 130 | 55 | 6.1 | Clinical history | Previous diagnosis | Longitudinal observational study: 130 children with AT (66 asthmatics and 64 controls) | AT associated in children with asthma with improvement in ACT scores (22–25) and decrease in emergency department/urgent care visits (1.88–0.4), oral corticosteroid courses (1.11–0.21), missed school days due to asthma (3.86–2.0), total missed parental work days due to illness (2.79–1.13), and circulating chitinase activity (0.4 nmol/L/mL/h) |
Abbreviations: SDB, sleep-disordered breathing; PSG, polysomnography; OSA, obstructive sleep apnea; AT, adenotonsillectomy; AHI, apnea–hypopnea index; ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification; AAE, acute asthmatic exacerbation; ASA, acute status asthmaticus; ARERs, asthma-related emergency room visits; ARHs, asthma-related hospitalizations; ACT, asthma control test; TST total sleep time.