Objectives: To determine the prevalence of periodic limb movements (PLMS) in children with obstructive sleep apnea (OSA) and assess the effect of adenotonsillectomy (AT) on PLMS.

Methods: Charts of children with OSA who underwent AT were reviewed for demographics, obstructive apnea-hypopnea index, and PLMS before and after AT. Prevalence of elevated periodic limb movement index (PLMI), defined as PLMS > 5 events/h, was compared with χ² test or Fisher's exact. Paired t-test and Wilcoxon signed rank test were used to compare PLMI pre-and post-AT.

Results: Elevated PLMI occurred in 114 (9.8%) of 1159 children (676 male,483 female, median age = 5). The prevalence of elevated PLMI was similar in gender, ethnicity, race, and weight categories. Compared to toddlers, the odds of elevated PLMI increased 22.1 times in preschoolers (p ≤ 0.001), 35.4 times in grade-schoolers (p ≤ 0.001), and 30.8 times in teenagers (p ≤ 0.001). Compared to children with mild OSA, the odds of elevated PLMI increased 2.3 times in children with moderate OSA (p = 0.007) and 1.9 times in those with severe OSA (p = 0.01). Of the 54 children who had a polysomnogram after AT, 46 (85%) resolved and 8 (15%) had persistent elevated PLMI. PLMI after AT decreased from 11.9 ± 7.6 to 2.9 ± 6.5 (p ≤ 0.001).

Conclusions: Elevated PLMI is common in children with OSA undergoing AT. PLMI resolves after AT in most children with OSA.

Keywords: adenotonsillectomy; children; obstructive sleep apnea; periodic limb movements.

© 2025 The American Laryngological, Rhinological and Otological Society, Inc.

目标： 确定阻塞性睡眠呼吸暂停（OSA）儿童周期性肢体运动（PLMS）的患病率，并评估腺扁桃体切除术（AT）对PLMS的影响。

方法： 回顾接受腺扁桃体切除术治疗的OSA患儿的病历，收集人口统计学信息、阻塞性呼吸暂停低通气指数以及手术前后PLMS的数据。使用卡方检验或费舍尔精确检验比较周期性肢体运动指数（PLMI）升高（定义为每小时PLMS > 5次）的发生率。采用配对t检验和Wilcoxon符号秩检验比较AT前后的PLMI。

结果： 在1159名儿童中，有114名（9.8%）的PLMI升高（其中676名为男性，483名为女性，中位年龄为5岁）。不同性别、种族和体重类别中的PLMI升高的发生率相似。与幼儿相比，学龄前儿童出现PLMI升高的几率增加22.1倍（p≤0.001），小学生增加了35.4倍（p≤0.001），青少年则为30.8倍（p≤0.001）。与轻度OSA的儿童相比，中度OSA的儿童PLMI升高的几率增加2.3倍（p=0.007），重度OSA的儿童增加了1.9倍（p=0.01）。在54名接受腺扁桃体切除术后进行多导睡眠图检查的患儿中，有46名（85%）PLMI恢复正常，而8名（15%）仍有持续性PLMI升高。AT后，PLMI从术前的11.9±7.6下降到2.9±6.5（p≤0.001）。

结论： 腺扁桃体切除术治疗OSA时，周期性肢体运动指数升高在儿童中很常见。绝大多数接受腺扁桃体切除术的OSA患儿PLMI会在术后恢复正常。

关键词： 腺扁桃体切除术；儿童；阻塞性睡眠呼吸暂停；周期性肢体运动。