Myths About Tonsillectomy, Sleep Apnea, and Bedwetting
May 23, 2011
One of the biggest myths within the sleep community is that taking out tonsils in children can cure sleep apnea. Yes, it can work to various degrees, sometimes dramatically, but it doesn’t work in all children. In fact, a recent large-scale meta-analysis showed that adenotonsillectomy was found to be significantly effective in about 60% of children. My 11 year old son was one such child. He had a dramatic response initially when he had his tonsils and adenoids taken out at age 5. But now, it’s slowly coming back, as expected.
Two recent studies continue to repeat the same kind of studies showing that removing tonsils and adenoids can help many children with their sleep apnea or bedwetting (sleep apnea is known to cause bedwetting in children as well as having to go often at night in adults). When the press reports on these kind of studies, they imply that surgery can be a “cure” for sleep apnea or bedwetting.
The adenotonsillectomy for sleep apnea article reported significant drops in the AHI in the mild group (2.6 to 1.5) as well as in the severe group (16.3 to 2.7). But notice that if you use the accepted AHI level of 1 as being abnormal, then their results weren’t that good. What they stressed, however, was that left heart enlargement improved with sleep apnea treatment.
The bedwetting article showed that in children who wet their beds only at night, they had about a 50% drop in bedwetting episodes. Those that had problems at night and during the day didn’t see any significant improvement. They went on to list various risk factors such as prematurity, such as prematurity, higher BMI, male sex, severe bedwetting and family history of bedwetting.
The reason why many of these children don’t respond to adenotonsillectomy (as well as those that respond only partially or relapse later on) is that they still continue to have narrow jaws and dental arches. They have various degrees of craniofacial narrowing and underdevelopment. Having smaller jaws and dental crowding can also make your tonsils larger (which causes more obstructed breathing).
I’m not minimizing the importance of these two studies. However, I wanted to point out that these type of solid scientific studies only perpetuate our black and white understanding of any type of intervention for obstructive sleep apnea.
If you had your child’s tonsils and/or adenoids taken out, did his/or problems improve? And if so, did it last?