Obstructive Sleep Apnea Associated With Tonsillar Hypertrophy in Adults

Six adults with tonsillar enlargement were shown via all-night polygraphic recordings to have varying degrees of upper airway obstruction during sleep. All but one of these patients were noted to have profound and debilitating daytime sleepiness. All patients had extremely loud snoring with anecdotal reports of apnea. Postoperatively all patients reported a marked reduction in snoring and substantial improvement in their daytime sleepiness. Postoperative sleep laboratory evaluation in four cases revealed nearly complete obliteration of upper airway obstruction and improvement in several objective sleep measurements, such as sleep-onset latency. We conclude that even relatively mild tonsillar enlargement can play an important role in the pathogenesis of obstructive sleep apnea.