Context Obstructive sleep disordered breathing (SDB) ranges from simple snoring to obstructive sleep apnoea syndrome (OSAS). In the paediatric population, reported incidence ranges from 1% to 11% worldwide. Untreated disease has been associated with cardiovascular and neurocognitive morbidity. 3 Surgical removal of the tonsils and adenoids is widely endorsed as the first-line treatment for otherwise healthy children with adenotonsillar hypertrophy. 5 Non-surgical treatment options include observation, continuous positive airway pressure (CPAP), medical therapy and orthodontic procedures or devices. As with any surgical procedure, risk of complications mandates careful consideration of the risk/benefit ratio compared with other options.