JAMA Original Investigation

Journal of the American Medical Association, December 5, 2023

A randomized clinical trial enrolling 459 children aged 3 to 12.9 years with snoring and an obstructive apnea-hypopnea index (AHI) less than 3, enrolled at 7 U.S. academic sleep centers from June 29, 2016, to February 1, 2021, and followed up for 12 months.

What’s Interesting about this article?

  • Participants were randomized to either early adenotonsillectomy or watchful waiting.
  • Children with early Adenotonsillectomy (T&A) had improved secondary outcomes of snoring, sleepiness, behavior, quality of life and decreased blood pressure. However, there was no change in cognitive function or attention.
  • An accompanying editorial by Inbal Hazikani, MD, Kathleen Billings, MD and Dana Thompson, MD states that poor sleep has a significant effect on the “parent-child dyad” as well as the symptoms mentioned in the article.

JournalDoc Comments:

  • Childhood T&A surgical procedures were common several decades ago because doctors believed they prevented recurrent strep throats and improved breathing function.
  • Pediatricians are now joining adult medicine physicians in recognizing the importance of sleep for overall health at all ages.
  • The benefits noted in the study must be balanced against the costs and risks of surgery.


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