Compared to adults, swollen tonsils and adenoids are the most common cause of obstructive sleep apnea (OSA) in children. The tonsils, which are 2 tissues at the back of the throat, can narrow and even block the airway if they start to enlarge, thus causing snoring and sleep apnea.
On this page you will learn:
Why tonsils become enlarged,
What are the symptoms of swollen tonsils,
How can enlarged adenoids and tonsils cause sleep apnea,
How to sleep with enlarged tonsils,
Remedies for enlarged tonsils,
How to treat sleep apnea caused by swollen tonsils.
Causes of Enlarged Tonsils
Bacteria and Viruses that Causes Tonsillitis
In children, swollen tonsils or tonsillitis is very common, because their tonsils become exposed for the first time to many infections.
The adenoids and tonsils are part of the immune system whose main purpose is to protect the body against bacteria and viruses. Because children are exposed to many new bacteriological agents, the immune system starts to react, thus the glands, lymph nodes, tonsils or adenoids can swollen.
Tonsillitis is caused by a streptococcal bacteria called Streptococcus pyogenes or Staphylococcusaureus. The doctor can discover this bacteria by sending a throat culture (passing a cotton swab across the tonsils) to a laboratory.
A blood test may also be done to check if the person with swollen tonsils has kissing disease (glandular fever or mononucleosis) which also causes the tonsils to be enlarged.
Allergy and Swollen Tonsils
Permanent or recurrent enlarged tonsils can be due to an allergy, mostly from mould or dust mite from the house. Children are mostly affected by them.
Food Sensitivity
Clinical studies found that tonsillitis is also caused by having sensibility or intolerance to dairy products, such as yogurt, milk, cheese or ice cream. Once discovered, the food problems can be eliminated, avoiding the recurrence of swollen tonsils.
Symptoms of Enlarged Tonsils
How do you know if your child has large tonsils?
Tonsillitis usually develop in 1 or 2 days from the infection, and the symptoms may include:
fever and chills,
headache and tiredness,
pain or discomfort while swallowing,
ache in the ears,
young kids can be fussy when eating or they even stop eating,
swollen glands in the neck having a red color,
sometimes the swollen tonsils will have white or yellow spots and mucous.
Here are some pictures:
Images with Enlarged Tonsils in Children
Swollen Tonsils and Sleep Apnea
In severe cases, the tonsils can swell enough to affect the breathing. In children, this is also the main risk factor for developing obstructive sleep apnea (OSA).
In sleep, the muscles of the human body relaxes, including those from the throat. In addition, if the glands from the throat are swollen, this will:
partially obstruct the airway causing snoring,
or, obstruct the airway completely, causing sleep apnea.
Symptoms of Sleep Apnea in Children with Swollen Tonsils
During sleep, kids with OSA can snore loudly and stop breathing during sleep for brief periods of time (apnea events or episodes). They start to awaken in order to breathe again.
These apnea events can disturb the child's sleep, and if sleep apnea remains untreated, it can affect his mental and physical development during growth.
During the day, children with OSA have symptoms of:
excessive daytime sleepiness and poor results in school,
difficulty staying awake or playing with other children,
they are also hyperactive or falling asleep in the class,
Behavior in Children with OSA and Tonsillitis
If a child has OSA, he can display hyperactivity and turbulent behavior at home and in school, daytime sleepiness, lack of attention and having difficulty coping with other groups of children. Read the study here.
Remedies for Enlarged Tonsils
Conventional Treatments
Surgery - Tonsillectomy is less common today than in the past, because swollen tonsils are considered a natural effort of the immune system to fight viruses and bacteria. In children, tonsillitis is usually cured within a few days with rest and care.
However, if the child feels unwell for a long period of time and is missing school, or if the tonsils grow too much and starts to have with ear infection, the doctor might recommend surgery.
Tonsillectomy is also recommended in children with sleep apnea and swollen tonsils.
Medication - if enlarged tonsils are caused by bacteria (discovered in the lab from the throat culture), the doctor usually prescribes antibiotics or penicillin. The injections are most effective, but also painful.
Treatment for Sleep Apnea in Patients with Swollen Tonsils
The surgery for tonsil removal - tonsillectomy - is the first option of treatment in patients with obstructive apnea and severe enlarged tonsils.
Because adult patients with OSA have a combination of risk factors of sleep apnea, tonsillectomy alone doesn't have high success rates (60% in patients with moderate OSA).
However, children have a higher success rate than adults, since enlarged tonsils is the main cause for their OSA.
A less painful surgery useful for children with OSA is coblation of partial tonsillectomy, which was proved to be effective in this study.
Recurrent Sleep Apnea
Although the tonsils are removed through surgery, in some children sleep apnea can reappear. It's important that after 1 year of surgery to schedule your child for a sleep study to rule out a recurrent sleep apnea. For these children, CPAP therapy is the first option.
Natural cure for enlarged tonsils usually involves resting and supportive care while the illness recedes in a couple of days.
Supportive care for a child with large tonsils means:
bed resting,
drinking more fluids than usual,
mouthwashing with warm salt water,
medication to reduce the fever (liquid paracetamol, but avoid giving your child aspirin for the risk of having Reye's Syndrome),
eating soups where vegetables and meat are simmered or drinking warm tea calms the body,
cold fruit drinks may help with sore throat pain.
Vitamins and minerals needed for reducing tonsillitis:
Because enlarged tonsils mostly appear due to the response of the immune system to bacteria and viruses, strengthening the immune system is important.
Children may be helped by taking multivitamin and mineral supplement, thus increasing the nutrient levels.
Vitamins for Tonsillitis
A clinical study revealed that patients with enlarged tonsils had low levels of vitamins B1, B2 and C. Read the study here.
Furthermore, another study found that vitamin D is also low in children with swollen tonsils and OSA. Read more here.
Vitamin E can also protect the body against infection.
Minerals, such as zinc, selenium and magnesium also have low levels in patients with recurring tonsillitis.
Note: Consult your doctor before trying zinc or vitamin C with antibiotics.
Herbal medicine for swollen tonsils in children:
Sore throats and tonsillitis should be the first option of treatment before trying antibiotics. However, you should consult your doctor if the symptoms persists.
Herbs for Enlarged Tonsils
Herbs with Essential Oils
- contain antibacterial oils which can help treating tonsillitis: Sage, Hyssop, Thyme, Camomile, Calendula.
Sage (Salvia officinalis) is the main herb for gargle than can alleviate sore throat and large tonsils.
Pour a cup of boiling water over 2 teaspoons of sage leaves and let it sit for 15 or 20 minutes. Then add a little salt. Gargle as needed.
Tannin Herbs
- contain tannin, which has the ability to treat tonsillitis: tormentil, raspberry, oak, agrimony.
Herbs containing mucilage
- contain a gelatinous substance secreted by plants that can soothe a sore throat: marshmallow, aloe vera, liquorice.
Images with Enlarged Tonsils in Children
Behavior in Children with OSA and Tonsillitis
Natural cure for enlarged tonsils usually involves resting and supportive care while the illness recedes in a couple of days.
