{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T08:15:09Z","timestamp":1773735309953,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n \n To evaluate the impact of pediatric adenotonsillectomy (T&A) on sleep architecture, related sleep factors, and respiratory parameters in children with obstructive sleep apnea (\n OSA<\/jats:styled-content>\n ), stratified by disease severity.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We analyzed 300 consecutive children who underwent full\u2010night polysomnography (\n PSG<\/jats:styled-content>\n ) before and after T&A between January 2021 and March 2022. Patients were stratified into severe (apnea\u2013hypopnea index [\n AHI<\/jats:styled-content>\n ]\u2009>\u200910\u2009events\/h or\n \n SpO\n 2<\/jats:sub>\n <\/jats:styled-content>\n \u2009<\u200980%) and very severe (\n AHI<\/jats:styled-content>\n \u2009>\u200930\u2009events\/h)\n OSA<\/jats:styled-content>\n groups. Correlations were assessed using Spearman analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The cohort included 233 (78%) severe, with a mean age of 6.85\u2009years (\n SD<\/jats:styled-content>\n \u2009=\u20094.83),\n BMI<\/jats:styled-content>\n 103% of the 95th percentile (\n SD<\/jats:styled-content>\n \u2009=\u200947.4), 61% male, and 55% Hispanic. T&A reduced the mean\n AHI<\/jats:styled-content>\n from 23.51 to 6.25 (\n p<\/jats:italic>\n \u2009<\u20090.001). Persistent severe\n OSA<\/jats:styled-content>\n was observed in 23% of patients, who demonstrated significantly shorter total sleep time (\n TST<\/jats:styled-content>\n ) (350.54 vs. 413.73\u2009min,\n p<\/jats:italic>\n \u2009<\u20090.001), less Stage\n N3<\/jats:styled-content>\n sleep (89.54 vs. 109.63\u2009min,\n p<\/jats:italic>\n \u2009=\u20090.001), less Stage R sleep (69.56 vs. 91.43\u2009min,\n p<\/jats:italic>\n \u2009<\u20090.001), and a higher arousal index (15.65 vs. 10.34,\n p<\/jats:italic>\n \u2009<\u20090.001) compared with those without persistent severe\n OSA<\/jats:styled-content>\n . Changes in\n TST<\/jats:styled-content>\n strongly correlated with changes in Stage\n N2<\/jats:styled-content>\n sleep (\n r<\/jats:italic>\n \u2009=\u20090.74; 95%\n CI<\/jats:styled-content>\n , 0.68\u20130.79;\n p<\/jats:italic>\n \u2009<\u20090.001) and Stage R sleep (\n r<\/jats:italic>\n \u2009=\u20090.68; 95%\n CI<\/jats:styled-content>\n , 0.61\u20130.74;\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n T&A significantly improves sleep architecture and respiratory outcomes in pediatric\n OSA<\/jats:styled-content>\n . However, deficits in restorative sleep stages persist in a subset of patients.\n <\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 4<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70219","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T12:15:44Z","timestamp":1761308144000},"page":"1912-1919","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Tonsillectomy on Sleep Architecture in Pediatric Patients With Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3581-3422","authenticated-orcid":false,"given":"Basir S.","family":"Mansoor","sequence":"first","affiliation":[{"name":"Department of Otolaryngology UT Southwestern Medical Center Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8966-1254","authenticated-orcid":false,"given":"Matthew","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology UT Southwestern Medical Center Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varun","family":"Pasapula","sequence":"additional","affiliation":[{"name":"Department of Pediatric Otolaryngology Children's Medical Center Dallas Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1419-6019","authenticated-orcid":false,"given":"Stephen R.","family":"Chorney","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology UT Southwestern Medical Center Dallas Texas USA"},{"name":"Texas Tech University Health Science Center El Paso Paul L. Foster School of Medicine El Paso Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6801-7544","authenticated-orcid":false,"given":"Yann\u2010Fuu","family":"Kou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology UT Southwestern Medical Center Dallas Texas USA"},{"name":"Texas Tech University Health Science Center El Paso Paul L. Foster School of Medicine El Paso Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia S.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology UT Southwestern Medical Center Dallas Texas USA"},{"name":"Texas Tech University Health Science Center El Paso Paul L. Foster School of Medicine El Paso Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2322-5347","authenticated-orcid":false,"given":"Romaine F.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology UT Southwestern Medical Center Dallas Texas USA"},{"name":"Texas Tech University Health Science Center El Paso Paul L. Foster School of Medicine El Paso Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818801757"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.11.060"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894241232477"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.2016"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0011356"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000508055"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.08.067"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200912\u20101930OC"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.162.2.9908058"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.124.3.948"},{"key":"e_1_2_9_12_1","unstructured":"U.S. Centers for Disease Control and Prevention (CDC) \u201cChild and Teen BMI Categories \u201dJune 24 2024 https:\/\/www.cdc.gov\/bmi\/child\u2010teen\u2010calculator\/bmi\u2010categories.html."},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0031\u20103955(16)36806\u20107"},{"key":"e_1_2_9_14_1","unstructured":"American Academy of Sleep Medicine \u201cThe AASM Manual for the Scoring of Sleep and Associated Events: Rules Tats Version 2.1 \u201d (2014) http:\/\/www.aasmnet.org\/scoringmanual\/default.aspx."},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.014"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleepadvances\/zpac029.147"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24427"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12185826"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.01.043"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016\u20103491"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818807917"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12549"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817700370"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25979"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817703921"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.183.1.1830175"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247\u2010006\u20100149\u20107"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2010.11.011"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.366"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70219","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70219","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T06:03:23Z","timestamp":1773727403000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,24]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/lary.70219"],"URL":"https:\/\/doi.org\/10.1002\/lary.70219","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,24]]},"assertion":[{"value":"2025-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}