An estimated 6–17% of children have sleep-disordered breathing, ranging from snoring to sleep apnea, which can cause behavioral, neurocognitive, cardiovascular, and cardiometabolic issues. A randomized trial 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 health care utilization among 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 health care system.

“Our findings demonstrate that overall health care 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% fewer doctor visits and 48% fewer prescriptions than their counterparts that did not receive surgeries.