Sleep apnea, hypersomnolence, and upper airway obstruction secondary to adenotonsillar enlargement.

The authors examined four children with substantial adenotonsillar enlargement that caused intermittent severe upper airway obstructive episodes, documented by all-night polygraphic monitoring of sleep and respirations. Previously unreported complications of severe adenotonsillar enlargement that were demonstrated included prolonged obstructive apneic episodes and disturbed sleep patterns. The children also exhibited daytime hypersomnolence. Polygraphic sleep studies after adenotonsillectomy confirmed improved sleep patterns and relief of the obstructive episodes. None of our patienqs had developed pulmonary hypertension, cor pulmonale, or other reported complications of prolonged upper airway obstruction, all of which may have been averted by early diagnosis and treatment.