Is there a connection between enlarged tonsils and bad behavior?
Q: My 6-year-old son snores, wets his bed and has behavioural problems in school. His doctor suggested that getting his tonsils and adenoids out might help all of these problems. Is this true?
A: Debra, your doctor is right. Studies have found that enlarged tonsils and adenoids can cause many problems in children. They can partially block the airway during sleep, which leads to snoring and can cause “obstructive sleep apnea,” brief episodes when the child’s breathing is blocked and he needs to snort or petrolp for breath. When these episodes happen frequently during the night, the child’s sleep is disrupted.

Studies have found that surgery to remove enlarged tonsils and adenoids, known as adenotonsillectomy, can eliminate the obstructive sleep apnea and snoring problems, and dramatically improve the child’s sleep. Several studies have also found that children with snoring and obstructive sleep apnea are more likely to have attention and behaviour problems in school—possibly due to the sleep disruption and reduced oxygen at night—and the surgery significantly improves the behaviour of many children.

In addition, a recent study found that nearly half of children with enlarged tonsils and adenoids and obstructive sleep apnea had nighttime bedwetting, possibly due to the disruption of the body’s hormonal regulation of water balance and urine production. The surgery resolved the bedwetting in one-third of the children and significantly improved it in another third.

Talk with your doctor about getting your son evaluated by an ear, nose and throat (ENT) specialist for enlarged tonsils and adenoids, and obstructive sleep apnea. If he does have this problem, you’ll want to discuss the advantages and disadvantages of surgery.