{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T13:05:31Z","timestamp":1764853531959,"version":"3.46.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Adenotonsillar hypertrophy is a prevalent pediatric condition that may affect children's health due to its association with obstructive sleep-disordered breathing (OSDB). This can negatively affect sleep quality, daytime behavior, neurocognitive development, and growth. This study aimed to evaluate the impact of adenotonsillectomy on children's sleep habits and behavior. A secondary objective was to explore differences in outcomes between children undergoing surgery for recurrent upper respiratory tract infections (URTIs) versus those with OSDB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A prospective longitudinal observational study was conducted from December 2023 to December 2024, enrolling 28 children aged 2\u201310 years undergoing adenotonsillectomy. Sleep and behavioral changes were assessed preoperatively and postoperatively (3\u20136 months) using the validated Children's Sleep Habits Questionnaire\u2014adapted Portuguese version and the Strengths and Difficulties Questionnaire\u2014Portuguese version. Paired samples\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -tests and general linear models were used for statistical analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Significant improvements were observed in several sleep parameters: sleep duration, parasomnias, sleep-related breathing disorders, daytime sleepiness, and the total sleep disturbance index (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001 for all). In the behavioral domain, hyperactivity was the only subscale to show statistically significant improvement (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.028). Surgical indication (OSDB vs. recurrent URTIs) did not significantly influence most outcomes, except for sleep-related breathing disorders, where greater improvement was noted in the OSDB group, as expected.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Adenotonsillectomy positively affects multiple dimensions of sleep, particularly reducing parasomnia episodes and hyperactivity symptoms, regardless of surgical indication. These findings underscore the importance of early recognition and management of pediatric adenotonsillar disorders to promote healthy sleep, improved daytime functioning, and long-term psychosocial development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/j.pbj.0000000000000309","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T13:00:39Z","timestamp":1764853239000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impact of adenotonsillectomy on sleep and behavioral outcomes in children: a longitudinal study"],"prefix":"10.1097","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4113-3259","authenticated-orcid":false,"given":"Francisco","family":"Alves de Sousa","sequence":"first","affiliation":[{"name":"Otorhinolaryngology and Head & Neck surgery, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"},{"name":"Doctoral Programme in Medical Sciences, Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Porto, Portugal"}]},{"given":"Margarida","family":"Camanho","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Porto, Portugal"}]},{"given":"Marta","family":"Rios","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Porto, Portugal"},{"name":"Sleep Laboratory, Pediatrics Department of Centro Materno Infantil do Norte, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9477-8822","authenticated-orcid":false,"given":"Manuel","family":"Ferreira de Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Porto, Portugal"},{"name":"Pneumology Unit and Neonatology Unit, Pediatrics Department at Centro Materno Infantil do Norte (CMIN), Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7041-0994","authenticated-orcid":false,"given":"Mariline","family":"Santos","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology and Head & Neck surgery, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal"},{"name":"Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Porto, Portugal"}]}],"member":"276","published-online":{"date-parts":[[2025,11]]},"reference":[{"issue":"1","key":"R1-20251204","doi-asserted-by":"crossref","first-page":"e001710","DOI":"10.1136\/bmjpo-2022-001710","article-title":"Adenoid hypertrophy in children: a narrative review of pathogenesis and clinical relevance","volume":"7","author":"Niedzielski","year":"2023","journal-title":"BMJ Paediatr Open"},{"issue":"3","key":"R2-20251204","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.wjorl.2021.04.003","article-title":"Anatomy and physiology of the palatine tonsils, adenoids, and lingual tonsils","volume":"7","author":"Arambula","year":"2021","journal-title":"World J Otorhinolaryngol Head Neck Surg"},{"issue":"1","key":"R3-20251204","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s43168-023-00247-w","article-title":"Impact of obstructive sleep apnea on cognition, mood, and fatigue: an MRI-based study","volume":"17","author":"Sweed","year":"2023","journal-title":"Egypt J Bronchol"},{"issue":"6","key":"R4-20251204","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.3122\/jabfm.2020.06.200038","article-title":"Current indications for tonsillectomy and adenoidectomy","volume":"33","author":"Randall","year":"2020","journal-title":"J Am Board Fam Med"},{"issue":"6","key":"R5-20251204","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1016\/S0031-3955(05)70521-6","article-title":"Tonsillectomy and adenoidectomy. 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