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

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. Up to 5 million children undergo surgery in the United States each year and it is estimated that over 50 % of these children display new onset maladaptive behaviors imme-diately following surgery (Kain, 2000; Kain, Wang, Mayes, Caramico, & Hofstadter, 1999; Thompson & Vernon, 1993). Further, when assessed at 2 weeks postopera-tively, up to 25 % of these children continue to evidence these behaviors (Kain et al., 1999). New onset maladap-tive behaviors are most commonly assessed by parent