LAUSR

Delta power is a known indicator of sleep drive and sleep pressure. Non-REM sleep delta power is increased in adults with sleep-disordered breathing, and lowered by treatment with continuous positive airway pressure (CPAP). Our purpose was to investigate the effect of tonsillectomy and adenoidectomy on delta power in children with sleep apnea. Here we report results from the pilot study phase of this project. A retrospective study was performed using consecutive children between the age of 5 and 15 years presenting to our Sleep Disorders Clinic between October 2019 and October 2022 who underwent tonsillectomy and adenoidectomy for obstructive sleep apnea and for whom polysomnographic data was available from before and after the procedure. Spectral power density analysis was performed using polysomnography data to determine delta power. A total of 41 children were screened of whom appropriate polysomnography studies were available for 10 children. The mean delta power prior to surgery was 2687.8±1081, while the mean delta power after surgery was 1737.9±522.9. Paired t-test was performed and showed a significant and large (~65%) reduction in delta power (Cohen’s D 0.91; p=0.018). Results of the pilot study showed a large and statistically significant reduction in delta power after tonsillectomy and adenoidectomy. This finding is consistent with the expected improvement in sleep pressure with correction of sleep apnea. Delta power represents a potent new metric to measure the biological efficacy and impact of surgery in children with sleep apnea. None