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Tonsillectomy May Prevent ADHD in Kids- Removing Tonsils May Prevent Obstructive Sleep Apnea Disorders in Children and Attention Deficit Hyperactivity Disorder

April 3rd 2006

Tonsillectomy May Prevent ADHD in Kids- Removing Tonsils May Prevent Obstructive Sleep Apnea Disorders in Children and Attention Deficit Hyperactivity Disorder


It appears that there may be a link between sleep apnea and Attention Deficit Hyperactivity Disorder (ADHD), but further research is needed to determine a causal relationship. Researchers from the University of Michigan Health System found that about half of the children with ADHD who underwent a tonsillectomy no longer met the criteria for ADHD one year later.

Obstructive Sleep Apnea (OSA) is a condition where the throat relaxes during sleep causing the sleeper to stop breathing.  The vast majority of people with this condition don’t realize they have it because it occurs when they are sleeping. OSA has been linked to hypertension, stroke and heart attack in adults.

According to the researchers, “On the whole, the 78 children who had their tonsils out were much more likely than a comparison group of 27 children to have had behavior and sleep problems at the start of the study. But by the end of the study, tests showed little difference between the two groups.”


The study supports previous research that showed a link between children with sleep related breathing problems and daytime behavior problems.  The Michigan team cautions that this does not prove cause and effect, and tonsillectomy is not usually a “cure” for ADHD. 

Interestingly, tonsillectomies were once performed on over a million children a year, but over the past few decades the procedure has become much less common.  Now the procedure, sometimes called a adenotonsillectomy when both the tonsils and structures called adenoids are removed, is performed on only a few hundred thousand children a year. 

According to lead author, Ronald Chervin, M.D., “These findings help support the idea that sleep-disordered breathing is actually helping to cause behavioral problems in children, and making them sleepy. This is one of the first studies to document, using gold-standard measures, that all of these sleep and behavior problems tend to resolve one year after enlarged tonsils and adenoids are removed."  Chervin is director of the U-M Sleep Disorders Center and co-leader of the U-M Center for Sleep Science.


The authors believe sleep problems are only part of the ADHD puzzle.  Only 11 of the 22 children with ADHD were not diagnosed with ADHD a year after the procedure.  The other 11 still had the condition. A few children even developed “new ADHD” a year after surgery.  This may be because damage from sleep-disordered breathing may occur in early years, even though the result is not seen until later. If confirmed, this would mean that early diagnosis and treatment of sleep-disordered breathing is important.

The research paper is published online in the April issue of the journal Pediatrics.

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By Dan Wilson
Best Syndication Staff Writer

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