Adenotonsillectomy Significantly Enhances Sleep in Children with OSA

A study published on **October 24, 2025**, in *Laryngoscope* reveals that adenotonsillectomy (T&A) significantly enhances sleep architecture and respiratory outcomes in children with obstructive sleep apnea (OSA). The research, led by **Basir S. Mansoor** from **UT Southwestern Medical Center** in Dallas, examined a cohort of **233 children**, with an average age of **6.85 years**, who were diagnosed with severe and very severe OSA.

Following the procedure, researchers observed a dramatic decrease in the mean apnea-hypopnea index (AHI), which fell from **23.51** to **6.25**. This improvement indicates a substantial reduction in the severity of sleep apnea among the pediatric patients studied.

Key Findings on Sleep Quality

The study highlighted that **23%** of the participants continued to experience persistent severe OSA after undergoing T&A. Those with ongoing severe OSA had notably shorter total sleep time (TST) compared to their peers without persistent severe OSA, averaging **350.54 minutes** versus **413.73 minutes**.

Additionally, children with persistent severe OSA exhibited less stage N3 sleep, with averages of **89.54 minutes** compared to **109.63 minutes**, and less stage R sleep, averaging **69.56 minutes** against **91.43 minutes**. The arousal index was also significantly higher for this group, at **15.65** compared to **10.34**.

The study found a strong correlation between changes in total sleep time and changes in both stage N2 sleep and stage R sleep, with correlation coefficients of **0.74** and **0.68**, respectively. These findings underscore the importance of monitoring sleep quality and respiratory parameters in children undergoing T&A.

Implications for Future Treatment

The authors of the study emphasize that while T&A is effective for most patients, the persistence of severe OSA in **23%** of the cohort suggests that some children may require additional monitoring or interventions beyond the surgery alone.

“Although T&A is effective for most patients, **23%** of our cohort maintained severe OSA postoperatively,” said the researchers. This observation calls for enhanced postoperative care strategies to ensure optimal health outcomes for affected children.

Overall, this research provides valuable insights into the effectiveness of adenotonsillectomy in treating pediatric OSA and highlights the need for tailored approaches to care for children who do not respond adequately to the procedure. The findings are crucial for healthcare providers aiming to improve sleep health in children suffering from this condition.

For further details, the study is available in *The Laryngoscope* under the title “The Effect of Tonsillectomy on Sleep Architecture in Pediatric Patients With Obstructive Sleep Apnea,” DOI: **10.1002/lary.70219**.