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Journal of Pediatric Psychology Advance Access published online on September 12, 2007
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsm073
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail:journals.permissions@oxfordjournals.org

Prevalence and Predictors of Significant Sleep Disturbances in Children Undergoing Ambulatory Tonsillectomy and Adenoidectomy

Jill E. MacLaren, PhD1,4 and Zeev N. Kain, MD, FAAP1,2,3,4

1Department of Anesthesiology, 2Department of Pediatrics, 3Department of Child Psychiatry, and 4Center for Advancement of Perioperative Health, Yale School of Medicine, New Haven, CT 06520, USA

All correspondence concerning this article should be addressed to Jill E. MacLaren, PhD, 333 Cedar Street, TMP 3, PO Box 208051, New Haven, CT 06520, USA. E-mail: jill.maclaren{at}yale.edu


  Abstract

Objective To evaluate children's sleep patterns before and after ambulatory surgery and to identify predictors of sleep decrements following surgery. Methods Participants were 55, 6- to 12-year-old children undergoing tonsillectomy and adenoidectomy. Sleep was assessed using actigraphy for 5 nights prior to and 5 nights following surgery. Parent state and trait anxiety, and child perioperative anxiety and temperament were assessed. Data on postoperative pain and use of analgesics were collected. Results Children had significantly less efficient sleep following surgery than before surgery. Approximately one-third of children demonstrated clinically significant decrements in sleep efficiency. Discriminant function analysis indicated less sociable and more anxious children were more likely to experience these sleep decrements, as were children who experienced greater pain in the postoperative period. Conclusion Children's sleep is an important consideration in recovery from surgery and this article takes a first step toward identifying predictors of the development of clinically significant sleep disruptions following surgery.

Key words: actigraphy; anxiety; pain; sleep; sociability; surgery..

Received March 28, 2007; revision received August 3, 2007; accepted August 3, 2007


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