The Connection Between ADHD and Sleep-Disordered Breathing in Children

As a functional dentist with expertise in treating sleep-disordered breathing (SDB) in children and adults, I have noticed a concerning trend over the past few years. Far too many times, I've witnessed children being diagnosed with attention-deficit / hyperactivity disorder (ADHD) when, in actuality, the root cause of their behavioral and attention issues may lie in SDB.

This misdiagnosis can lead to unnecessary medication and missed opportunities for effective treatment. The connection between ADHD and SDB in children is a complex and often misunderstood one. Parents should know the potential link and its implications on their child's life.

Related Symptoms of ADHD and SDB

ADHD is a common neurodevelopmental disorder in children, characterized by persistent patterns of inattention, hyperactivity, and impulsivity. However, it's essential to understand that these symptoms are not exclusive to ADHD. They can also result from poor sleep quality, especially in cases of SDB. SDB is a broad term encompassing a range of conditions that can disrupt a child's sleep patterns, such as snoring, sleep apnea, and mouth breathing.

Children with SDB often experience fragmented sleep, reduced sleep efficiency, and lower sleep duration. These sleep disruptions can have many adverse effects, including excessive daytime sleepiness, irritability, poor academic performance, and difficulties with memory and concentration. These are all symptoms that overlap with ADHD.

One of the critical features of SDB is snoring, which gets overlooked as a minor annoyance. However, persistent snoring in children can indicate partial airway obstruction, leading to decreased oxygen levels during sleep. Snoring in children should be addressed as this can negatively impact a child's cognitive and behavioral functions during waking hours.

Research has consistently demonstrated a strong correlation between SDB and inattentive and hyperactive behaviors in children. Children misdiagnosed with ADHD can potentially lead to the unnecessary prescription of stimulant medications.

Addressing SDB in Children

Recognizing the connection between SDB and ADHD-like symptoms is a crucial step toward providing children with the proper treatment. Addressing sleep-related issues can lead to substantial improvements in a child's overall behavior and academic performance. Leaving SDB untreated can lead to cognitive impairment, behavioural issues, impaired growth and development, and cardiovascular problems in severe cases.

When children with SDB receive proper treatment, the results are often dramatic. This treatment can include orthodontic intervention, lifestyle changes, or surgical measures if necessary. In some cases, treatment for SDB can result in such significant improvements that the child no longer meets the criteria for an ADHD diagnosis.

What You Can Do as a Parent

For parents who suspect that their child may have SDB, it is essential to consult with healthcare professionals who specialize in sleep-related disorders. A general dentist with expertise in SDB, like myself, can be a valuable resource in diagnosing and managing these issues. Parents can take proactive steps to ensure their child gets adequate and quality sleep. These steps may include:

• Monitoring Sleep Patterns: Keep an eye on your child's sleep patterns, like snoring, mouth breathing, pauses in breathing, or restless sleep.
• Promoting a Healthy Sleep Environment: Ensure that your child's sleep environment is conducive to quality rest, with a comfortable mattress, a dark and quiet room, and a consistent sleep schedule.
• Encouraging a Balanced Diet: Limit sugar and caffeine intake, especially before bedtime. A well-balanced diet can contribute to overall health, including better sleep.
• Oral Health and Breathing: Book regular dental check-ups to identify potential issues related to SDB, such as mouth breathing or dental malocclusions.

Seeking the Right Diagnosis

While ADHD is a legitimate neurodevelopmental disorder that affects many children, it's essential to consider other factors like SDB. A proper evaluation by healthcare professionals specializing in sleep-related issues can help distinguish between ADHD and SDB, preventing misdiagnosis and unnecessary medications. Misdiagnosing SDB as ADHD and treating it with medications can potentially exacerbate the underlying sleep issues, causing more harm than good.

To properly assess whether a child's symptoms are due to ADHD or SDB, a comprehensive evaluation is essential. This evaluation should include a thorough medical history, physical examination, and, most importantly, a sleep study.

The Power of Sleep

I have witnessed firsthand in my practice the significant impact of addressing sleep problems in children. A good night's sleep is fundamental to a child's health and well-being. When their sleep quality improves, their academic performance and overall behaviour do as well. By educating parents about the connection between SDB and ADHD, I hope that they, along with healthcare providers, will ensure their child receives the correct diagnosis and the most effective treatment for their specific needs.

A good night's sleep can be a game-changer for a child, and every child deserves the chance to reach their full potential.

Author:

Dr. Mandeep Johal, D.M.D., is a tongue-tie professional, a practitioner of functional dentistry, a renowned guest speaker, and an advocate for children’s health. She is the owner of Family Dental Centre in Guelph as well as a dental advisor for Well.ca.

She takes an integrative approach to traditional dentistry by looking at the root cause of issues with the mouth and jaw and how they are connected to whole-body wellness.