Adenotonsillectomy Enhances Sleep Quality in Children with OSA

A recent study highlights the benefits of adenotonsillectomy (T&A) for children suffering from obstructive sleep apnea (OSA), showing significant improvements in sleep quality and respiratory outcomes. The research, published online on October 24, 2025, in the journal Laryngoscope, was conducted by a team led by Basir S. Mansoor from UT Southwestern Medical Center in Dallas.

The study analyzed the effects of T&A on sleep architecture and respiratory parameters in a group of 233 children, with a mean age of 6.85 years. Among these participants, 78% were diagnosed with severe OSA. The findings revealed a significant drop in the mean apnea-hypopnea index, decreasing from 23.51 to 6.25 after the procedure.

Key Findings on Sleep Metrics and Outcomes

Despite the overall improvement, the study noted that 23% of the children continued to experience severe OSA post-surgery. Those with persistent severe OSA exhibited notably shorter total sleep time (TST) compared to their peers, averaging 350.54 minutes versus 413.73 minutes. Additionally, they showed less stage N3 sleep, with 89.54 minutes compared to 109.63 minutes, and less rapid eye movement (REM) sleep, averaging 69.56 minutes versus 91.43 minutes.

Moreover, the arousal index was significantly higher in the group with persistent severe OSA, registering 15.65 compared to 10.34 in those without ongoing severe symptoms. The research indicated a strong correlation between changes in TST and alterations in stage N2 and R sleep, with correlation coefficients of 0.74 and 0.68, respectively.

Implications for Postoperative Care

The authors of the study emphasized the need for careful postoperative evaluation for certain patients, noting, “Although T&A is effective for most patients, 23% of our cohort maintained severe OSA postoperatively.” This suggests that some children may require additional monitoring or interventions beyond T&A to ensure optimal recovery and health outcomes.

This research underscores the importance of personalized care in pediatric sleep disorders and highlights the potential for further studies to explore the long-term effects of T&A on children with varying degrees of OSA. The findings contribute valuable insights to the ongoing dialogue about effective treatments for sleep-related issues in children, paving the way for enhanced clinical practices.

For detailed information, refer to the study by Basir S. Mansoor et al., titled “The Effect of Tonsillectomy on Sleep Architecture in Pediatric Patients With Obstructive Sleep Apnea,” published in The Laryngoscope.