"Getting your tonsils out used to be just part of childhood  a rite of passage for children in the s and s. Then it fell out of favor. But tonsillectomy is back. Today the most common reason for the surgery is sleep disordered breathing a broad diagnosis that includes sleep apnea and snoring. About  percent of elementaryschoolage children snore. Doctors say snoring can cause bedwetting behavior problems short stature and poor school performance. Thats a far cry from the s and s when tonsillectomy was used to fight frequent sore throats. Back then it was the most popular surgery in the United States. In the s sitcom Leave It to Beaver http Beaver Cleaver was so impressed by his dads tales of ice cream and pretty nurses that he schemed to have his tonsils out even though he didnt need it. Turning Point For Tonsillectomies It was becoming unacceptable to just take tonsils out because they were there or you had a few infections. People were growing up with their tonsils. Richard Rosenfeld an ear nose and throat doctor at SUNY Downstate in Brooklyn N.Y. The tonsils are two glands that sit at the base of the tongue and are part of the bodys immune system. The premise of tonsillectomies back in their heyday was that tonsils get infected themselves and no longer help fend off germs. Then doctors started noticing that kids were still getting sore throats even after having their tonsils taken out. But it wasnt until clinical trials were completed in the early s that there was proof that tonsillectomy really only helped children with severe recurrent throat infections. It was becoming unacceptable to just take tonsils out because they were there or you had a few infections says Richard Rosenfeld an ear nose and throat doctor at SUNY Downstate in Brooklyn N.Y. People were growing up with their tonsils. Article continues after this message from our sponsor But growing up with tonsils can create another problem snoring. Lisa Moran of Takoma Park Md. remembers what it sounded like when her son Tyler Scorza now age  slept. It was loud Moran says. You could hear him through he closed door down the hall snoring and he would occasionally stop breathing. At first Tylers pediatrician thought hed outgrow the snoring. But he wasnt sleeping well and often didnt have any energy. The doctor recommended a head XRay and the radiologist said that though Tylers adenoids were enlarged they werent that bad. By then Tyler had been dealing with this for almost three years. He started getting frequent nasal infections. So his parents took him to an ear nose and throat doctor. He said sure the adenoids are swollen. But the real problem is the tonsils Moran recalls. He showed us on the Xray that there was a tiny passage between the tonsils and the back of his throat  very small. Enlarged tonsils and adenoids are the most common cause of sleepdisordered breathing in children. So the doctor recommended tonsillectomy. Complications From Surgery But Tylers parents were worried about the surgery. Its usually done as an outpatient procedure now but with general anesthesia. Thats never without some risk. Your child is under says Moran completely under. This is not a local. Other complications include pain after surgery and the risk of bleeding about  percent of people have complications that require readmission to the hospital. Despite hundreds of studies theres still surprisingly little research on whether tonsillectomy really helps reduce the risk of sore throats. The operation continues to be controversial. Whats A Sleep Study Sleep studies are a way for doctors to diagnose sleep disorders like apnea by observing patients overnight while they sleep. During a sleep study the patient is connected to an array of sensors monitoring brainwaves eye movements heart rate breathing and bloodoxygen levels. This information called a polysomnogram lets doctors see whether the patient has stopped breathing and for how long. Apnea in adults happens when  seconds pass without breathing for children its a disruption of two cycles of inhaling and exhaling. Some patients can also use portable sleep monitors to record whats happening in their sleep as an alternative to the sleep study but that approach is not as comprehensive. Many sleep disorders can be diagnosed without costly sleep studies which can run anywhere from  to severalthousand dollars. More children are undergoing sleep studies as awareness of the condition  particularly in children  rises. The American Academy of Sleep Medicine http says about  percent of children have obstructive sleep apnea. Before a sleep study is ordered doctors typically ask for medical and sleep histories http and a physical exam.  Eliza Barclay No less a personage than President Obama dissed tonsillectomy when he was stumping for health care overhaul in July . In a prime time news conference http_doctors_taking_tonsils_out_for_money_instead_of_diagnosing_it_as_allergies.html Obama said that doctors may think  You know what I make a lot more money if I take this kids tonsils out.  Rosenfeld disputes Obamas claim saying insurers usually pay a surgeon  to  for tonsil surgery. Sleep Study Before Tonsillectomy The picture is further clouded because not all children with big tonsils have sleepdisordered breathing or frequent throat infections. Because of that in  the American Academy of Pediatrics httpaappolicy.aappublications.orgcgicontentfullpediatrics recommended that children have a sleep study before surgery is considered. About  tonsillectomies are performed in the United States each year. Obviously parents could use some help in deciding whether surgery is needed. In January the American Academy of Otolaryngology issued its first guidelines on tonsillectomy http in children. With sore throats the ENTs recommend waiting and treatment with antibiotics if needed unless a child has more than seven infections in a year. Theyd recommend surgery if a child has five or more throat infections a year for two years or three or more in three years. There have been very few randomized studies on the effects of tonsillectomy for sleepdisordered breathing. Most of the researchers have asked parents or children whether they noticed improvements and looked at a single measure like behavior or quality of life. Still the ENTs recommend tonsillectomy for sleepdisordered breathing saying it reduces symptoms in most children. Tylers family decided to go ahead with the surgery they went to the hospital at  a.m. and Tyler was home by noon. The doctors said he would be out of school for a week but a throat infection kept him home a second week. His classmates sent him getwell cards. A year later Tyler is feeling great. And his snoring is gone. Completely gone his mom says. You can hear a pindrop quiet when he sleeps. Tyler still hears snoring at night he says. But he knows that the culprit is not him or the family dog. Its Dad."