Adenotonsillectomy does not improve children’s behavior, although it does improve their sleep

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Sleep Disorders | Sleep Review

Children with sleep-disturbed breathing are likely to display aggressive and hyperactive behavior during the day.

The recommended treatment is an adenotonsillectomy – the removal of the adenoid and tonsils – to fix not only snoring but behavior as well.

According to new research from the University of South Australia (UniSA), while the operation changes a child’s snoring, it does not change their behavior, although parents and doctors often have misconceptions.

Working with the University of Adelaide and the Women’s and Children’s Hospital, the researchers studied the behavior of children six months, two and four years after an adenotonsillectomy for clinically diagnosed sleep disturbed breathing disorder (SDS). The research is published in Sleep Medicine.

The study compared it to a control group of non-snoring children and showed improvements in children’s sleep and quality of life, but not behavior.

[RELATED: Do Sleep Studies Predict Who Benefits from Adenotonsillectomy? Maybe Not]

Lead researcher Kurt Lushington, PhD, MPsych, professor at UniSA, says the results provide realistic expectations for parents and practitioners, especially if the child is already diagnosed with a behavioral disorder like ADHD.

“As most parents would confirm, when a child sleeps poorly, their behavior is reflected in the next day,” Lushington said in a press release.

“However, when snoring is affecting their quality of sleep, parents often hope that by correcting this problem, they will also correct any behavioral problems associated with it. I would like to recommend the opposite, but it is not necessarily the case.

“Our research shows that a child’s quality of life improves after an adenotonsillectomy, which is clearly linked to firmer, less disrupted sleep. However, we did not notice any significant changes in behavioral disorders. “

But it’s not all bad news.

“In clinical practice, when examining a child postoperatively, many parents report significant improvements in behavior and alertness,” says Lushington.

“Undoubtedly this is comforting, but other factors are likely to play a role – most likely more sleep for the whole family and less worry for the parents, which together means a calmer, more attentive, and emotionally responsive environment during the day.

“In addition, there is evidence that an intervention could be helpful much earlier in life. We may be late leaving the operation. “

“Previous work by UniSA has shown that adenotonsillectomy can be important at a younger age of 3 to 5 years. Our previous work suggested this as well, so there is room for further research.

“At this point, it’s important to make sure parents know exactly what an adenotonsillectomy can and cannot do for their child.”

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