Can Removing Tonsils Help Sleep Apnea?

Tonsillitis is a rather common disease that causes generalized discomfort and pain when swallowing. Since this condition involves the tonsils (located in the throat area), people wonder whether having them removed can help with the symptoms of other disorders that also affect this area, such as sleep apnea.

In this article, we look in detail into the link between the tonsils and sleep apnea. We will also explore what the experts say about the impact of surgical removal of the tonsils on sleep apnea symptoms.

What is tonsillitis?

To start with, let’s look at what exactly is tonsillitis to understand its connection to sleep apnea.

This disease is characterized by inflammation in the tonsils, two glands that sit left and right of the throat, plus another two located at the back of the palate. 

Since they are part of the immune system, the main function of these glands is to help the body fight any infection that may come into the body through the mouth. You can think about them as the body’s equivalent of a goalie in a soccer game. 

Having said that, and like actual goalies, these glands aren’t invincible. They may be affected by viral or bacterial infections, to which they respond with swelling. Sometimes, the inflammation can be so severe that makes swallowing very hard and painful.

In addition to a sore throat, other common symptoms are fever, fatigue, headaches, earaches, and a persistent cough. In most cases, these symptoms clear up on their own after a few days, and sometimes (but not always) require a course of antibiotics.

The problem is that in some people, tonsil inflammation happens too often or becomes chronic. When this happens, doctors may suggest a tonsillectomy, or the surgical removal of the problematic glands. 

Is tonsillitis connected to sleep apnea?

Indeed, it can be. This sleep disorder is one of the complications that can result from tonsillitis. In particular, obstructive sleep apnea or OSA can develop if the glands are swollen repeatedly or for a long time and cause a blockage in the upper airways. 

When such a blockage to normal airflow occurs, the person may experience common OSA symptoms, including snoring, snorting, frequent breathing interruptions while asleep, and waking up gasping for air. 

On the other hand, enlarged or swollen tonsils are known to cause obstructive sleep apnea, although this is more common in children than in adults. 

In people who have already been diagnosed with obstructive sleep apnea, tonsillitis can make the symptoms worse and increase the number of breathing interruptions that happen through the night. 

Here it’s worth mentioning that OSA is a serious health condition that can cause significant physical and emotional distress. People affected by OSA experience cognitive problems, mood swings, daytime fatigue, and have a higher risk of being involved in accidents. The condition is also a risk factor for heart disease and high blood pressure

With that being said, many people wonder if having a tonsillectomy will help improve not only their chronic sore throat, but also their OSA symptoms and their potential health effects. Let’s see what medical experts say about this. 

Will tonsil removal help with sleep apnea?

In some cases, a doctor may recommend surgical tonsil removal to alleviate or eliminate snoring in children. The idea is that once the swollen glands are removed, they will no longer interfere with the normal flow of air and will therefore elliminate the appearance of OSA symptoms, such as snoring. 

For example, researchers in one study found that removing the problematic glands eliminated snoring in nearly 80% of the children examined. 

What if a tonsillectomy doesn’t work?

In adults, tonsillectomies are not the first line of treatment for OSA, since there are other factors that play an important role in the symptoms. These factors include:

  • Being overweight or obese.
  • Sinus problems. 
  • Excess fat around the neck area. 
  • Sleeping on your back. 
  • An unusual shape or size of the neck, tongue, or windpipe. 

In other words, you may have a tonsillectomy but still continue to battle with obstructive sleep apnea as long as the issues mentioned above aren’t resolved. 

This is not to say that tonsillectomy is not recommended to adults with OSA. This surgery can help in some cases, along with changes in diet, lifestyle, and sleeping habits. 

For example, a Swedish study examined the outcomes of tonsillectomies in OSA patients. Six months after surgery, most participants had gone from experiencing 40 breathing interruptions per night to just 7. There is no doubt that in this case, the surgery did help with OSA symptoms and general sleep quality, but it’s important to note that all participants had a normal body weight.

Another study carried in Finland looked at the overall effectiveness of having a tonsillectomy as the sole treatment for OSA. 

In this study, the baseline for success was considered to be a 50% reduction in the number of nighttime breathing interruptions with a maximum of 20 events per night, post-op. 

After surgery, approximately 47% of patients experienced success. But again, it must be noted that the surgery did not “cure” OSA, although it did have an impact on its most severe symptoms. 

In addition, and although you can usually go home the same day you have surgery, you should bear in mind that recovery time tends to be longer in adults than in children. The length of the post-op period varies from person to person, but it’s not unusual for it to take at least a couple of weeks, which is twice as long as in pediatric patients. 

After surgery, if there’s no improvement, it’s possible that your sleep specialist recommends that you start or continue to follow standard OSA treatment, which involves Continuous Positive Air Pressure therapy or CPAP. This treatment, along with the effects of tonsil removal, can greatly improve sleep quality, reduce daytime fatigue, and minimize the impact that obstructive sleep apnea could have on your health.