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Recent research links many ADHD diagnoses in children to sleep-related breathing disorders (SRBD) like sleep apnea.
Signs of SRBD include snoring, breaks in breathing, mouth breathing, and frequent night terrors.
SRBD can produce symptoms that mimic ADHD, such as inattention and hyperactivity, which impacts a child’s academic performance.
Treating SRBD can improve behavior and even eliminate the need for an ADHD diagnosis in some cases.
Parents should consult healthcare providers about potential sleep disorders before considering ADHD medication.

Over the last ten years, we’ve seen a noticeable uptick in ADHD diagnoses among children. Interestingly, recent research suggests that a significant portion of these cases may not truly be ADHD. Instead, issues with behavior are being linked to sleep-related breathing disorders (SRBD), including conditions like sleep apnea.

What is Sleep-related Breathing Disorder (SRBD)

Sleep-related Breathing Disorder involves repeated instances where breathing stops temporarily during sleep. Soft tissues near the throat’s back — such as the tonsils or the tongue — can obstruct the child’s breathing passage, which narrows the airway. These tissues may also vibrate as air flows past, leading to snoring. This problem often escalates when the child lies on their back. That position tends to push the lower jaw backward, which pushes the tongue toward the airway and tightens the blockage further.

Children in higher-weight bodies may face a greater risk of sleep apnea. Excess fatty tissue in the soft palate further reduces the airway’s width. To determine if your child might be experiencing a sleep-related breathing disorder, pay attention to their sleep behaviors. Watching your child as they sleep could give you valuable insights to share with a healthcare provider.

Key signs to watch for include:

Snoring at a young age
Breaks in breathing
Persistent mouth breathing
Frequent tossing and turning
Sudden night terrors
Regular bed-wetting

The Link Between ADHD & Sleep-related Breathing Disorder

The connection between ADHD and sleep-related disorders, particularly sleep-disordered breathing (SDB), is intricate and significant. SDB — which includes conditions like snoring and sleep apnea — can produce symptoms that closely mimic those of ADHD, such as inattention, hyperactivity, and impulsivity. These conditions often result in poor sleep quality. Children experience fragmented sleep, reduced sleep efficiency, and shorter sleep duration. The adverse effects can include excessive daytime sleepiness, irritability, poor academic performance, and difficulties with memory and concentration — symptoms that overlap with those of ADHD. Learn more here.

How ADHD Type Affects Sleep Patterns

Sleep problems in children with ADHD tend to vary depending on the type of ADHD. Children with predominantly inattentive symptoms may have later bedtimes. Those with predominantly hyperactive-impulsive symptoms might struggle more with insomnia. The combination of both symptom types often leads to poor sleep quality and later bedtimes together.

Notably, many ADHD symptoms look a lot like sleep deprivation. Forgetfulness and difficulty concentrating mirror adult sleep deprivation. Hyperactive and impulsive behaviors reflect childhood sleep deprivation. This overlap makes it hard to tell whether issues stem from ADHD or a lack of sleep. That confusion can lead to misdiagnoses or undetected sleep disorders. Experts generally recommend screening for sleep problems before prescribing ADHD medication.

The Brain’s Role in Sleep and ADHD

ADHD-related sleep problems may stem from impaired arousal, alertness, and regulation circuits in the brain. A delayed circadian rhythm — with later melatonin production — may also play a role. Despite the similarities between certain sleep disorders and ADHD symptoms, researchers have not conclusively identified consistent sleep abnormalities specific to ADHD. Children and adults with both ADHD and a sleep disorder often report more severe ADHD symptoms and a lower quality of life. They also face a higher likelihood of depression, anxiety, hyperactivity, inattention, and difficulty processing information.

Given the potential for misdiagnosis, parents and healthcare providers need to understand the connection between ADHD and sleep disorders. Proper evaluation and treatment help ensure that children receive the correct diagnosis and the most effective interventions for their specific needs.

Treating Sleep Apnea in Children

Addressing sleep-related issues in children can lead to significant improvements in behavior and academic performance. Untreated SDB can cause cognitive impairment, behavioral issues, impaired growth and development, and cardiovascular problems. Treatment for SDB may involve orthodontic intervention, lifestyle changes, or surgical measures if necessary. In some cases, treating SDB produces such significant improvements that a child no longer meets the criteria for an ADHD diagnosis.

Treatment for Younger Children

For younger children who are still in their growth phase, a dental device known as a palatal expander has shown strong benefits. This device gradually broadens the palate or roof of the mouth by gently parting the bones, which do not fully join until the adolescent years. While its primary use is to make additional space for crowded teeth, the expansion process can also enhance airflow. This potentially alleviates some breathing-related sleep issues.

Treatment for Older Children

For older children whose growth has ceased, Oral Appliance Therapy (OAT) might offer relief. OAT uses a custom-made dental appliance that adjusts the jaw’s position during sleep. This keeps the tongue from blocking the airway, which minimizes the risk of sleep disruptions. We discuss additional treatment options for older children below.

The first step toward improving your child’s sleep quality and overall health is identifying the underlying cause of their sleep disturbances. If sleep apnea is a concern, we encourage you to reach out to our office for further information or to set up a consultation appointment. This conversation will pave the way to discovering the most effective treatment solution for your child’s specific needs.

How Dr. Jung Can Help Your Child

Our sleep specialist in Mansfield is an excellent starting point for addressing mouth-breathing concerns because we excel at recognizing the signs of this condition, especially those related to oral and facial development. Dr. Jung can identify the dental impacts of mouth breathing, such as misaligned teeth or an improper bite. She can also refer you to other specialists, like allergists or ENT doctors, for comprehensive care. Our familiarity with your child’s oral health history puts us in a strong position to detect and address these issues early. Dr. Jung has also undergone specialized education and training to address mouth breathing in kids, making her an expert in these areas. Here are some of our specialized services:

Comprehensive Evaluation: We conduct thorough assessments to identify the underlying causes of mouth breathing, ensuring a tailored treatment plan.
Orthodontic Solutions: Our treatments may include orthodontic interventions to correct structural issues contributing to mouth breathing.
Laser Therapy: The advanced laser helps treat sleep disorders in children by tightening areas in the mouth that limit airflow and cause snoring. This is a painless procedure.
Oral Appliance Therapy: Most of our young patients benefit greatly from sleeping with a special mouthguard that encourages proper jaw alignment and nasal breathing. Younger kids may also benefit from habit appliances like palatal expanders and space maintainers. Learn more about oral appliance therapy here.
Myofunctional Therapy: We offer exercises and therapies aimed at strengthening oral and facial muscles, promoting healthy breathing patterns.
Parental Guidance: We educate parents about the signs, consequences, and preventive measures of mouth breathing in children.
Collaborative Care: We collaborate with other healthcare professionals for holistic care, addressing any related respiratory or sleep issues.

Don’t Wait, Invest In The Future Of Your Child!

Dr. Jung has undergone extensive training to be the best of the best in treating sleep disorders in children to prevent ADHD. Far too often, children receive medication for a problem that has an underlying cause. If your child is struggling with ADHD or a sleep disorder, give our office a call, and we will be happy to help you find a solution!

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Educational Disclaimer: This blog post is intended for educational purposes only and does not constitute individualized dental or medical advice. Every patient’s oral health situation is unique. Please schedule a comprehensive consultation with Dr. Jiyoung Jung or a qualified dental professional before making any treatment decisions. The information shared here is not a substitute for a personalized clinical evaluation.

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