Tonsillectomy associated with improved sleep and behavior in children with breathing disorders

Children diagnosed with sleep-disordered breathing appear to sleep better and have improved behavior following removal of their tonsils and adenoids, according to a report in the October issue of Archives of Otolaryngology–Head & Neck Surgery, one of the JAMA/Archives journals.

Sleep-related breathing disorders include snoring, obstructive sleep apnea syndrome and other conditions affecting air flow, according to background information in the article. As many as 11 percent of children may develop these conditions. Sleep-disordered breathing in children has been associated with attention-deficit/hyperactivity disorder (ADHD), hyperactive behavior, academic problems, bedwetting, learning disabilities, sleepiness during the day, headaches and other complaints.

Julie L. Wei, M.D., of the University of Kansas School of Medicine, Kansas City, and colleagues studied 117 children (average age 6.5) who were diagnosed with sleep-disordered breathing and who underwent adenotonsillectomy (removal of the tonsils and adenoids, tissue at the back of the throat). Parents completed surveys about their children’s sleep and behavior before and six months after surgery.

Among the 71 children who completed the six-month follow-up, scores for sleep problems and behavioral difficulties were significantly lower after six months than before surgery. This included reductions in cognitive (thinking, learning and memory) problems, hyperactivity, oppositional behavior and ADHD symptoms.

The researchers also found correlations between sleep and behavior scores before and after surgery. “Not only did both behavior and sleep improve independently before and after adenotonsillectomy for sleep-disordered breathing in our group of patients, but they also improved in correlation with each other,” the authors note.

(Arch Otolaryngol Head Neck Surg. 2007;133(10):974-979. Available pre-embargo to the media at www.jamamedia.org.)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.