Respiratory disturbance during sleep due to adenoid-tonsillar hypertrophy.

The pathophysiologic results of respiratory disturbances caused by adenoid-tonsillar hypertrophy are reported. In each case, we monitored intraesophageal pressure to accurately assess respiratory effort, and recorded a sleep diary to detect disorganized sleep habits and disturbed sleeping-waking rhythms. We noticed that great respiratory effort existed not only during light sleep, but was also continuously observed during deep sleep despite the total disappearance of obstructive apneas. Furthermore, upper airway obstruction caused by adenoid-tonsillar hypertrophy and hypoxemia during sleep in the rapid eye movement stage were found to be closely related to the sudden infant death syndrome. A sleep diary recording sleep habits and regularity of night sleep seems to provide reliable indicators for the determination of surgical intervention.