UTA, University of Maryland team up to better understand sleep apnea treatment in children

September 20, 2019

Every year, more than 500,000 children have their tonsils and adenoids surgically removed as a way to treat symptoms related to sleep apnea, making it one of most widely performed pediatric surgical procedures in the United States.

Clinicians believe that the benefits of surgery can be seen in an improvement in the severity of sleep apnea, as measured by a sleep study. The downside of the sleep study is that it is expensive, costing as much as $3,000, and often inaccessible in many parts of the country. Despite these issues, the test is recommended as part of the decision during and after surgery.

Gautam Das, a professor in UTA's Computer Science and Engineering Department, worked with lead researcher Amal Isaiah, M.D., Ph.D., a pediatric ear, nose and throat surgeon, and Kevin Pereira, M.D.--both from the University of Maryland School of Medicine--to understand whether sleep studies predicted the improved outcomes following surgery for sleep apnea in children. For their analysis, they re-analyzed the data collected during the Childhood Adenotonsillectomy Trial (CHAT), a randomized trial published in 2013 that compared adenotonsillectomy with watchful waiting for seven months to treat sleep apnea in children.

The team found that the resolution of sleep apnea, as determined by sleep study results, did not correlate with most of the improvements, including behavior, cognitive performance, sleepiness and symptoms of attention deficit hyperactivity disorders.

Their findings were published in the September 2019 issue of the journal Pediatrics. "Causality is very complex. There are a lot of factors that explain why things happen, and analysis has to be thorough to ensure that all variables are considered for modeling," Das said. "We applied causal mediation analysis and discovered additional relationships through the process that showed there were more factors at work in the original CHAT study

That original study randomly allocated 450 children with sleep apnea to two groups based on whether they would have surgery immediately or after a period of waiting.

The trial results concluded that surgery led to greater improvement in most domains, including behavior and quality of life in children. However, an important question remained--how did they get better? Clinicians previously suggested that the underlying mechanism is an improvement in the severity of upper airway obstruction defined by the sleep study.

Das and Isaiah worked together to address this problem using causal mediation analysis, which estimates the potential outcomes of surgery by simulating those related to watchful waiting and keeping the level of the mediator--the change in sleep apnea severity--constant. With this algorithm, the researchers built a network with treatment and outcomes as nodes, and the edges replicated the effects of treatment as explained by the change in sleep apnea severity.

"This new process allowed us to see if the causality paths estimated by the algorithm were different from what was assumed in the original study," Das said.

Das first collaborated with Isaiah while Isaiah was a trainee at UT Southwestern, and their current collaboration shows the potential of multidisciplinary research in data science, computer science and medicine.

The work is an example of how UTA researchers are contributing to knowledge in data-driven discovery and health and the human condition, two themes of the University's Strategic Plan 2020.

"As data science becomes increasingly significant and sophisticated, it is important to understand how it can be applied to existing research and discovery to provide additional context and improve upon our knowledge," said Hong Jiang, chair of UTA's Computer Science and Engineering Department. "Dr. Das' collaboration with Dr. Isaiah has shed new light on an accepted medical practice that will allow physicians to make better-informed decisions for half a million children undergoing tonsillectomy each year."
-- written by Jeremy Agor

University of Texas at Arlington

Related Sleep Apnea Articles from Brightsurf:

Sleep apnea may be risk factor for COVID-19
The question of sleep apnea as the risk factor for COVID-19 arose in a study conducted by the Turku University Hospital and the University of Turku on patients of the first wave of the pandemic.

Untreated sleep apnea is associated with flu hospitalization
As we approach flu season, adults with obstructive sleep apnea may want to take extra precautions.

Losing tongue fat improves sleep apnea
Using magnetic resonance imaging (MRI) to measure the effect of weight loss on the upper airway in obese patients, researchers found that reducing tongue fat is a primary factor in lessening the severity of OSA.

More cancer cases among women with sleep apnea
Women with severe sleep apnea appear to be at an elevated risk of getting cancer, a study shows.

New evidence on the association of shortened sleep time and obstructive sleep apnea with sleepiness and cardiometabolic risk factors
A new study in the journal CHEST® may change the way we think about sleep disorders.

Synthetic cannabis-like drug reduces sleep apnea
A synthetic cannabis-like drug in a pill reduced apnea and daytime sleepiness in the first large multi-site study of a drug for apnea.

Inflammation may precede sleep apnea, could be treatment target
Inflammation is traditionally thought of as a symptom of sleep apnea, but it might actually precede the disorder, potentially opening the door for new ways to treat and predict sleep apnea, according to researchers.

Concerns that sleep apnea could impact healthspan
The number of people with obstructive sleep apnea has steadily increased over the past two decades.

Sleep apnea and insomnia combination linked with depression
A new study found that men with sleep apnea and insomnia have a higher prevalence and severity of depressive symptoms than men with sleep apnea or insomnia alone.

Anti-nausea drug could help treat sleep apnea
An old pharmaceutical product may be a new treatment for obstructive sleep apnea, according to new research presented today by University of Illinois at Chicago and Northwestern University scientists at the SLEEP 2017 annual meeting in Boston.

Read More: Sleep Apnea News and Sleep Apnea Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.