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Tonsil Removal Might Cure Bedwetting in Some Kids With Sleep Apnea


3 Star


Tonsil Removal Might Cure Bedwetting in Some Kids With Sleep Apnea

Our Review Summary

The story also pointed out clearly that research presented at meetings has not yet been rigorously peer-reviewed and must be viewed in that light. This should be the standard in reporting from medical meetings. The story could have been improved if it had included some cost information, addressed the potential harms from tonsil surgeries, and provided some explanation of the alternatives to surgery.


Why This Matters

Children who can’t sleep can bring a household to its knees. Add to that constant bedwetting and you have a toxic combination of constantly cranky kids and forever frustrated parents. This story addresses both of these issues separately and gives readers clear information about how this research relates to both problems, while explaining many of the necessary caveats along the way.


Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not discuss costs. Tonsillectomies are not cheap, and the cost definitely should have been factored in here. Also, there is a question about whether insurance would cover a tonsillectomy that was done primarily to resolve a bedwetting problem.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?


Right in the lead, the story quantifies the benefits, saying, “Half of children with sleep apnea who also wet the bed might stop their bedwetting if their tonsils or adenoids are removed, new research suggests.” The story satisfies our criteria of absolute risk reduction. However, we would have liked to have seen more details, such as the average length of time it took for half of the 417 children to stop wetting. And, do the researchers mean COMPLETELY stopped wetting, or went from wetting most nights to wetting rarely, for example.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

This is a big omission in the story. Any story about surgical procedures needs to address the potential harms from surgery.The basic risks of surgery, including infections, bleeding, and complications of anesthesia should have been mentioned.

Does the story seem to grasp the quality of the evidence?


This story includes a sentence that we would like to see, in some version, in more stories about research released at conferences. It says, “Research presented at medical meetings should be viewed as preliminary until it has been published in a peer-reviewed medical journal.” Those 20 words go a long way toward providing readers the right context for processing these findings.

There still is room for improvement.  The story never explains whether this was a randomized clinical trial or a cohort study – so no evaluation of the quality of the evidence. It didn’t explain how researchers measured bedwetting, if there were other concurrent interventions, or anything else about the kids in the study.

Nonethless, because of the attempt to inject some caution about these results, we’ll give it the benefit of the doubt.

Does the story commit disease-mongering?


The story does not engage in disease-mongering. It takes great pains to explain to readers that surgery may not be the solution for their child’s sleeping problems and their child’s bedwetting problems. It also is very clear about the potential audience for this surgery, beginning with the headline, which says, “Tonsil removal may cure bed wetting in some children with sleep apnea. Children with sleep apnea are a small subgroup, and that group is made even smaller by including only those children who wet the bed. Then, this headline and the story, go even further to make it clear that not all of those children will be cured. We would have liked to have seen a few additional pieces of information about the other effects of sleep apnea in children, such as daytime sleepiness and difficulty in school. Most parents would not consider surgery to solve something like bedwetting, which in the majority of children will resolve on its own.

Does the story use independent sources and identify conflicts of interest?


This story has more sources than most. It quotes the lead researcher on the study and then four independent sources from a range of specialties. They bring some great perspectives to the story and help people understand the connections between different behaviors. “Children with sleep apnea can be difficult to rouse, which may cause the bedwetting, said Dr. Dennis Kitsko, an otolaryngologist at the Children’s Hospital of Pittsburgh. ‘But not every child with sleep apnea will wet the bed, and not every bedwetter will have sleep apnea.'”

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story does a good job talking about the different causes of bed wetting but not the potential treatments. “There are many other causes of bedwetting, Lakshmanan said. “About 5 to 7 million children are bedwetters, and the causes fall into three main groups: bladder issues, sleep-related problems and the kidneys,” he explained. “The children in this study wet the bed due to sleep-related problems.” We would have particularly liked to hear an estimate for the number of children who resolve bedwetting (even “abnormal” bedwetting into grade school) on their own. From a healthcare perspective and a parenting perspective, do we really want to do operations on kids to end this annoyance?

Does the story establish the availability of the treatment/test/product/procedure?

Not Applicable

Not applicable. The story does not explicitly state how common tonsillectomies are, but the surgery is so routine at this point, we do not feel there is a need for further explanation.

Does the story establish the true novelty of the approach?

Not Satisfactory

Treating sleep apnea surgically for bedwetting is not novel, but this story does not make a clear case for novelty or against it.

Does the story appear to rely solely or largely on a news release?


The story does not rely on a news release.

Total Score: 5 of 9 Satisfactory


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