Adenotonsillectomy Reduces Sleep Apnoea Symptoms in Children

The major causes of sleep apnoea in children are enlarged tonsils and adenoids. Treatment for sleep apnoea in children can either entail the watchful waiting approach or on the other hand doctors monitor the condition to perform surgery at the opportune time.

A study conducted sought to evaluate the impact of sleep apnoea surgery (adenotonsillectomy) versus the watchful wait treatment approach on the behavior and attention of children. Adenotonsillectomy which is the removal of adenoids and tonsils is a commonly performed procedure. It is one of the most common pediatric surgery procedures done. More than half a million procedures are done every year as treatment for obstructive sleep apnoea.

The Director of the Program in Sleep and Cardiovascular Medicine at the Brigham and Women’s Hospital, Dr. Susan Redline was head of the group of researchers who conducted the study. The research findings were published in the New England Journal of Medicine and presented at the American Thoracic Society’s International Conference. Their findings are that early adenotonsillectomy for a child with sleep apnoea improves behavior, improves quality of life and reduces sleep apnoea symptoms. 

During the study, 464 children suffering from sleep apnoea between the ages of 5 and 9 were examined and randomly placed into two groups. 194 children had adenotonsillectomy done as treatment to sleep apnoea while the remaining 203 children were placed under watchful waiting. About half the number of the children in the study was overweight in order to evaluate the effect of surgery on overweight children with sleep apnoea problems.

Developmental Neuropsychological Assessment tests done seven months later indicate improvement in attention, behavior and cognitive functioning in the children who had early adenotonsillectomy. Other improvements seen are improved sleep apnoea symptoms and better quality of life. The benefits of surgery were even evident for children struggling with obesity. It should be noted that cognitive functioning is not a factor of surgery alone but that of medical management as well.

Another of the results obtained from the study are that putting off surgery may as well be a solution to obstructive sleep apnoea. The children in the control group/watchful waiting group showed improvement over the course of the study, only that those who had surgery showed pronounced improvements. Provided the children are put under medical attention and care, sleep apnoea symptoms do worsen.

Undiagnosed sleep apnoea will cause daytime sleepiness and the attention and behavioral problems in children affecting learning. Sleep apnoea may further increase the risk of obesity, high blood pressure, diabetes, and heart problems.