Getting your tonsils removed: A (sometimes) cure for bedwetting

ResearchBlogging.orgKids who snore are more likely to wet the bed than kids who don’t. Strangely enough, the reason may be their too-big tonsils, which can cause the snoring and sleep apnea affecting 1 in 10 kids. In 2013, Michigan scientists reported that removing the tonsils stopped bedwetting in 20 out of 46 kids, almost three times the number who would stop bedwetting on their own. But while removing the tonsils can stop bedwetting, it doesn’t always–and the difference between may lie in kids’ sleep patterns before the surgery.

These results surprised the scientists: like other researchers and doctors, they’d expected that the difference would be linked to different levels of the hormones controlling blood fluid levels. Instead, they found that the cured kids had had their sleep disturbed more often by their snoring or apnea before surgery. Their bodies also got less oxygen during sleep–which, along with their snoring and bedwetting, was relieved by the surgery. In contrast, the kids who weren’t cured had woken up more often before surgery. Other factors–such as ADHD or other medical issues not involving the tonsils–might lie behind these kids’ bedwetting.

Researchers have long suspected that the link between large tonsils, sleep problems, and bedwetting comes from the tonsils blocking kids’ throats, which changes the internal pressure in their chests. In response, heart cells release brain natriuretic peptide–a hormone which triggers the body to excrete more water and salt into the blood, increasing the urge to pee. Presumably, getting rid of the large tonsils would make kids’ chest pressure normal and reduce the amount of brain natriuretic peptide. The Michigan scientists caution that this suspected link may still be true, and that their preliminary study needs to be repeated with more kids.

Reference:

Kovacevic L, Wolfe-Christensen C, Lu H, Toton M, Mirkovic J, Thottam PJ, Abdulhamid I, Madgy D, & Lakshmanan Y (2014). Why does adenotonsillectomy not correct enuresis in all children with sleep disordered breathing? The Journal of urology, 191 (5 Suppl), 1592-6 PMID: 24679871

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3 thoughts on “Getting your tonsils removed: A (sometimes) cure for bedwetting

  1. This is an interesting article because it shows preliminary evidence that a very common childhood surgery has become the cure for tonsillitis, sleep apnea, and possibly bedwetting. Perhaps in addition to the reduction of the natriuretic peptide, the children who were cured from bedwetting were not getting the proper sleep cycles or amount of sleep, so their bodies were not able to wake themselves when they had the urge to pee. More studies definitely need to be done on this topic. It would also be interesting to look at what was causing the enlarged tonsils to begin with. There are so many questions that would be interesting to find the answers to. Was it due to tonsillitis, genetics, lifestyle (obesity)? Do they end up suffering from sleep apnea later on in their adult life? Did their attention span and grades improve once their sleep apnea was cured? Sleep apnea is a very serious condition that can interfere with your daily life. It would be great to have more research done from different angles on this topic.

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  2. Good question about what was causing the tonsil enlargement, Chelsea! According to this article in American Family Physician (http://www.aafp.org/afp/2010/0915/p669.html), common causes of pediatric tonsillar hypertrophy include pharyngitis and inflammation. The Merck Manual also suggests that allergies, respiratory irritants, and gastrointestinal reflux can lead to enlarged adenoids and tonsils (http://www.merckmanuals.com/home/childrens_health_issues/ear_nose_and_throat_disorders_in_children/enlarged_tonsils_and_adenoids.html).

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