In a randomized trial, Mass General Brigham researchers found the surgical removal of tonsils and adenoids was effective for children with snoring and mild sleep apnea
An estimated 6 to 17 percent of children have sleep-disordered breathing, ranging from snoring to sleep apnea, which can cause behavioral, neurocognitive, cardiovascular, and cardiometabolic issues. A new study from Mass General Brigham researchers reveals that adenotonsillectomy—the surgical removal of tonsils and adenoids—is an effective early intervention for these children. Their results are published in JAMA Pediatrics.
"To my knowledge, ours is the first randomized trial to evaluate healthcare utilization amongst children with sleep-disordered breathing," said corresponding author Susan Redline, MD, MPH , director of Programs in Sleep Medicine Epidemiology and Sleep and Cardiovascular Medicine at Brigham and Women's Hospital , a founding member of the Mass General Brigham healthcare system. "Our findings demonstrate that overall healthcare utilization is reduced with adenotonsillectomy surgery, supporting early intervention for children with mild sleep-disordered breathing. Excluding the post-operative period, this means that for every 100 children, 125 encounters and 253 prescriptions can be avoided in the first year following surgery."
Unlike prior retrospective studies on the impact of early adenotonsillectomies on sleep-disordered breathing, this new study was a randomized, 12-month trial. Between 2016 and 2022, the researchers followed 381 children ages 3 to 13 with mild sleep-disordered breathing. Children that underwent early adenotonsillectomies had 32 percent fewer doctor visits and 48 percent fewer prescriptions than their counterparts that did not receive surgeries.
Authorship: In addition to Redline, Mass General Brigham authors include Jessie P Bakker and Rui Wang. Additional authors include Fang Zhang, Raouf Amin, Cristina M Baldassari, Ronald D Chervin, Susan L Garetz, Fauziya Hassan, Sally Ibrahim, Stacey L Ishman, Erin M Kirkham, Ariel Linden, Ron B Mitchell, Kamal Naqvi, Carol L Rosen, Kristie Ross, Ignacio E Tapia, Lisa R. Young, and Phoebe K Yu.
Disclosures: Redline reports consulting fees from Eli Lilly; serving as an unpaid consultant to ApniMed Inc., unrelated to this manuscript; unpaid Board of Director for the National Sleep Foundation and Alliance of Sleep Apnea Partners; and grants from NIH that supported this work. Additional disclosures for authors can be found in the paper.
Funding: This study was supported by research contracts 1U01HL125307 and 1U01HL125295 from the National Institute of Heart, Lung and Blood Institute of the National Institutes of Health.
Paper cited: Bakker, JP et al. "Effect of adenotonsillectomy on healthcare utilization in children with snoring and mild sleep apnea" JAMA Pediatrics DOI: 10.1001/jamapediatrics.2025.0023
