Surgery in children with mild sleep-disordered breathing linked to fewer doctor visits and medications
March 17, 2025
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Press release
Monday, March 17, 2025
An NIH-funded study supports the use of adenotonsillectomy in this at-risk group of patients.
What
Surgical removal of enlarged tonsils and adenoids in children with mild sleep-disordered breathing (SDB) appears to significantly reduce the frequency of doctor visits and prescription drug use in this group, according to a clinical study funded by the National Institutes of Health (NIH). The results, published in JAMA Pediatrics, show that surgery, called adenotonsillectomy, was linked to a 32% reduction in doctor visits and a 48% reduction in prescription drug use in children with mild disease.
Sleep-disordered breathing (SDB) refers to sleep-disordered breathing that can range from loud snoring to occasional pauses in breathing. Approximately 6 to 17 percent of children in the United States are affected, and for those with moderate to severe cases, adenotonsillectomy is a commonly used standard treatment. It can help reduce breathing problems, minimize behavioral disturbances, and lower the risk of high blood pressure, sleep apnea, and sleep apnea. declaredand other problems that may occur if left untreated. A recent clinical trial funded by the NIH showed that in children with mild sleep-disordered breathing, surgery helped reduce blood pressure and improve sleep and quality of life.
In this new study, researchers sought to determine whether adenotonsillectomy, compared to watchful waiting (no intervention) with supportive care, was associated with fewer doctor visits and prescriptions. To find out, the researchers analyzed data from a randomized clinical trial of 459 children and adolescents with mild sleep-disordered breathing, recruited between 2016 and 2021 and followed for one year. Participants were aged 3 to 12 years and were studied at seven academic sleep centers in the United States.
During the trial, half of the participants underwent adenotonsillectomy, and the other half received non-surgical supportive care, which included standardized education on healthy sleep and lifestyle and guidance for untreated allergies or asthma. An analysis after the 12-month study period revealed 32 fewer doctor visits and 48 fewer prescriptions among participants who underwent adenotonsillectomy, compared with those who did not have the operation. For every 100 children, this equates to 125 fewer doctor visits and 253 fewer prescriptions—including for pain, skin, and respiratory medications—given in the first year after surgery.
The reduction in physician visits included fewer office visits and outpatient procedures, particularly for sleep and respiratory problems, but the mechanisms linking SDB treatment to healthcare outcomes are unclear.
Study
Bakker JP, et al., Effect of adenotonsillectomy on health care utilization in children with snoring and mild sleep apnea. JAMA Pediatrics. 2025; DOI: 10.1001/jamapediatrics.2025.0023
Who
Marishka Brown, Ph.D., director of National Center on Sleep Disorders Research at the National Heart, Lung, and Blood Institute of the NIH, is available for interviews to discuss this study.
Contact
To request an interview with Dr. Brown, please email nhlbi_news@nhlbi.nih.gov
About the National Heart, Lung, and Blood Institute (NHLBI): The NHLBI is the world leader in conducting and supporting research on heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, visit www.nhlbi.nih.gov.
About the National Institutes of Health (NIH): The NIH, the nation's medical research agency, comprises 27 institutes and centers and is part of the U.S. Department of Health and Human Services. The primary federal agency conducting and supporting basic, clinical, and translational medical research, the NIH investigates the causes, treatments, and cures for common and rare diseases. For more information about the NIH and its programs, visit www.nih.gov.
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