Tonsillectomy can improve kids' sleep, behavior

NEW YORK (Reuters Health) - Children with sleep disordered breathing who undergo adenotonsillectomy - surgical removal of the tonsils and adenoids -- may not only start sleeping better, but may also show improvements in behavior, the results of a new study suggests.

Sleep disordered breathing refers to a spectrum of breathing disorders, ranging from snoring to obstructive sleep apnea syndrome, a condition in which the patient stops and starts breathing many times over the course of the night. One side effect of obstructive sleep apnea syndrome is chronic fatigue during the day.

Often, the problem stems from enlarged tonsils and adenoids, masses of tissue that help catch incoming germs; the tonsils are located in the back of the throat, while the adenoids dwell behind the nose.

Studies have found that children with sleep disordered breathing also have an elevated rate of behavioral problems, including attention-deficit hyperactivity disorder (ADHD), and poor school performance. It's thought that poor sleep quality contributes to these problems.

Adenotonsillectomy can cure children's sleep disordered breathing, and the results of the new study suggest that accompanying behavioral issues may also improve, researchers say.

"For children with behavior problems, chronic snoring may contribute to such behaviors, and if the snoring is addressed, there can be significant improvement in their quality of life," lead study author Dr. Julie L. Wei, of the University of Kansas School of Medicine in Kansas City, told Reuters Health.

The study, published in the Archives of Otolaryngology -- Head & Neck Surgery, included 117 children with sleep disordered breathing who underwent adenotonsillectomy. Before the surgery and six months after the procedure, parents completed questionnaires on their children's sleep disordered breathing symptoms and behavioral problems, including inattention, hyperactivity and defiance.

Overall, Wei's team found, there was a correlation between the extent of children's nighttime breathing problems and their daytime behavioral problems. When their sleep disordered breathing symptoms improved after surgery, so too did their behavior.

Studies in recent years have shown that poor sleep can be a "significant factor" in children's behavior and emotional well-being, Wei noted.

This study, she said, supports those findings, and suggests that sleep disordered breathing treatment can aid the daytime problems linked to poor sleep.

SOURCE: Archives of Otolaryngology -- Head & Neck Surgery, October 2007.