Surgical removal of enlarged tonsils and adenoids in children with mild sleep-disordered breathing (SDB) appears to significantly reduce the frequency of medical office visits and prescription medicine use in this group, according to a clinical study supported by the National Institutes of Health (NIH).

The findings, published in JAMA Pediatrics, show that the surgery, called adenotonsillectomy, was tied to a 32% reduction in medical visits and a 48% reduction in prescription use among children with a mild form of the condition.

SDB refers to breathing disturbances during sleep that can range from loud snoring to occasional breathing pauses. About 6 to 17% of children in the United States have it, and for those with moderate to severe cases, adenotonsillectomy is a standard treatment commonly used. It can help reduce breathing problems, minimize behavioral issues, and also lower the risk of high blood pressure, full-blown sleep apnea, and other problems that may occur if the condition is left untreated. A recent NIH-supported clinical trial showed that for children with mild SDB, the surgery helped lower blood pressure and improve sleep and quality of life.  

In the new study, researchers sought to determine whether adenotonsillectomy in comparison to watchful waiting (non-intervention) with supportive care is associated with fewer health care encounters and prescriptions. To find out, the researchers analyzed data from a randomized clinical trial that involved 459 children and adolescents with mild SDB who were recruited between 2016 and 2021 and followed for one year. The participants were ages 3 to 12 and were studied at seven academic sleep centers in the U.S.

During the trial, half the participants received an adenotonsillectomy, and the other half received supportive care without surgery, which included standardized education on healthy sleep and lifestyle and referral for untreated allergies or asthma. An analysis after the 12-month study period found 32% fewer health care encounters and 48% fewer prescriptions used among participants who underwent adenotonsillectomy, compared to those who did not undergo the surgery. For every 100 children, this equates to 125 fewer health care encounters and 253 fewer prescriptions — including for pain, skin, and respiratory medications — administered during the first year following surgery.

The reduced health care encounters included fewer office visits and outpatient procedures, particularly for sleep- and respiratory-related problems, but the mechanisms linking SDB treatment to health care outcomes are not clear.

Up to 25% of new mothers suffer from postpartum depression, which can significantly impact their parenting behavior and the wellbeing of their children. A new study from the University of Illinois Urbana-Champaign looks at long-term effects of early maternal depression on children, underscoring the need to provide adequate support for mothers who might be struggling.

“We wanted to explore how mother’s early postpartum depression might influence children’s executive function and emotional overeating, focusing on the psychological mechanisms driving the effects,” said lead author Samantha Iwinski, postdoctoral research associate in the Department of Human Development and Family Studies at Illinois.

“Emotional overeating is about using food to cope with stress or emotions rather than using it to satisfy hunger. Instead of thinking about food as a source of nourishment or enjoyment, it becomes a coping strategy for negative emotions. If children aren’t able to talk about their emotions or show how they really feel, they may react to a stressful situation by grabbing something to eat,” Iwinski said.

The study included families participating in the Midwest STRONG Kids2 project, which investigates how individual biology interacts with the family environment to promote healthy eating habits in young children. Mothers filled out questionnaires to assess postpartum depression at six weeks, children’s emotional functioning at 24 months, and children’s eating behavior at 48 months.

The researchers analyzed the data using the biopsychosocial pathways model, which outlines how interactions between biological, psychological, and social factors affect health outcomes, including appetite self-regulation. They focused on postpartum depression as a critical social factor predicting children’s emotional overeating, mediated through emotional and cognitive psychological processes.

“In our sample, almost 12% of mothers met the criteria for postpartum depression, and we found that maternal postpartum depression at six weeks negatively influenced children’s executive function with inhibition and emotional control at 24 months and overeating at 48 months,” Iwinski said.

“Inhibition involves being able to control one’s attention, behaviors, and thoughts. This can include doing what may be appropriate in a given situation, which may involve overriding internal predispositions For example, if a child is doing their homework and the TV is playing, they can direct their attention and focus on their homework rather than the TV. Emotional control is about being able to regulate oneself when certain situations are happening; for example, crying might help in response to distress.”

In addition to the indirect effects on eating behavior through executive functioning, there was also a direct correlation between maternal depression and children’s overeating. 

Mothers who suffer from postpartum depression may be less responsive to their children’s cognitive and emotional needs, which can affect healthy development and capacity for self-regulation. Women with postpartum depression symptoms may also engage in appetite fluctuation, modeling this behavior for their children. 

The researchers say their findings underscore the need for early intervention and support for women who suffer from depression. 

“By supporting the mother’s mental health, we’re really supporting the families, because of the long-term effects on children. It’s important to have early identification of what might be happening in order to help families teach their children healthy strategies for coping with emotions, such as play, mindfulness, or even just talking about our feelings,” Iwinski stated.

“Teachers and other supportive adults can also participate in supporting children and families. For example, they can be looking at eating patterns, noticing how children might be reacting in certain situations, and if food might be a coping mechanism for them. They can then use that information to talk about other ways to deal with emotions and bring the family more into the conversation.”

The paper, “Maternal postpartum depression and children’s emotional overeating: The mediating role of executive function,” is published in Eating Behaviors. Authors include Samantha Iwinski, Sehyun Ju, Qiujie Gong, and Kelly Bost.

Underscoring the critical role of sleep in diabetes prevention, investigators from the Global Centre for Asian Women’s Health (GloW) and the Department of Obstetrics and Gynaecology, based at the NUS Yong Loo Lin School of Medicine (NUS Medicine), in collaboration with Harvard T.H. Chan School of Public Health, Brigham and Women’s Hospital and Harvard Medical School, has identified a significant link between sleep health and the risk of developing Type 2 diabetes (T2D) among women with a history of gestational diabetes (GDM).

GDM is one of the most common pregnancy complications, affecting up to 30% of pregnancies globally. Women with a history of GDM are nearly 10 times more likely to develop T2D later in life compared to those without GDM. More strikingly, in Singapore, more than 40 per cent of women may develop T2D within 5 years following pregnancies complicated by GDM.  While lifestyle factors such as diet and exercise are well-known preventive measures, this study sheds light on the often-overlooked role of sleep health in mitigating diabetes risk.

By prioritising better sleep, women with a history of GDM can take proactive steps toward reducing their long-term risk of developing T2D and improving overall metabolic health. Led by Professor Zhang Cuilin, Director of GloW, and Dr Yin Xin, Research Fellow at GloW, their team analysed data of nearly 3,000 women with a history of GDM over 17 years from the Nurses’ Health Study II and found that those who slept six hours or fewer per night had a 32 per cent higher risk of developing T2D compared to those who met the recommended seven to eight hours of sleep.

Additionally, regular snoring—defined as snoring most nights per week or every night—was associated with a 61% increased risk of T2D. Women who experienced both short sleep duration and regular snoring faced more than double the risk compared to those with healthy sleep patterns. Beyond increasing diabetes risk, regular snoring was also associated with unfavourable glucose metabolism biomarkers, including elevated levels of HbA1c, insulin, and C-peptide, all of which signal potential metabolic dysfunction.

“Our research highlights that improving sleep habits—such as increasing sleep duration and addressing snoring—can be a powerful, actionable step in preventing Type 2 diabetes among women with a high-risk of diabetes,” said Prof Zhang. She further emphasised, “Given the rising prevalence of GDM and diabetes, particularly in Asia, it is crucial to expand prevention strategies to include the improvement of sleep health, especially for women with a history of GDM. Dr Yin also pointed out that, “Women with GDM may have had sub-optimal glucose metabolism even before pregnancy.”

Having opened new avenues for diabetes prevention, the study’s researchers are now looking to develop tailored interventions for Asian women that include improving sleep quality, diet, and other lifestyles, and to better understand underlying molecular mechanisms.

The study titled ‘Sleep Characteristics and Long-Term Risk of Type 2 Diabetes Among Women With Gestational Diabetes’ was published in JAMA Network Open.