Treating ADD/ADHD in Children With a Sleep Disorder

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 […]

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. The child’s breathing passage can get obstructed by soft tissues near the throat’s back — such as the tonsils or the tongue — which narrows the air passage. These tissues may also vibrate as air flows past, leading to snoring. This problem often escalates when the child lies on their back, as it tends to cause the lower jaw to move backward, further obstructing the airway by pushing the tongue towards it.

Children who are overweight may face a greater risk of sleep apnea, attributed to excess fatty tissue in the soft palate, which 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. Observing your child as they sleep could provide 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 lead to symptoms that closely mimic those of ADHD, such as inattention, hyperactivity, and impulsivity. These conditions often result in poor sleep quality, characterized by fragmented sleep, reduced sleep efficiency, and decreased sleep duration. The adverse effects of such disrupted sleep patterns 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.

Interestingly, sleep problems in individuals with ADHD tend to vary depending on the type of ADHD. Those with predominantly inattentive symptoms may have later bedtimes, while those with predominantly hyperactive-impulsive symptoms might suffer more from insomnia. The combined presence of hyperactive-impulsive and inattentive symptoms often leads to both poor sleep quality and later bedtimes. Notably, many symptoms of ADHD resemble those of sleep deprivation, such as forgetfulness and difficulty concentrating in adults, and hyperactive and impulsive behaviors in children. This resemblance can make it challenging to discern whether issues are due to ADHD or a lack of sleep, potentially leading to misdiagnoses or undetected sleep disorders. Consequently, experts generally recommend screening for sleep problems before prescribing ADHD medication​​.

Furthermore, ADHD-related sleep problems may stem from impaired arousal, alertness, and regulation circuits in the brain or a delayed circadian rhythm with a later onset of melatonin production. Despite the similarities between certain sleep disorders and ADHD symptoms, consistent sleep abnormalities in individuals with ADHD have not been conclusively identified. Children and adults with both ADHD and a sleep disorder often report more severe ADHD symptoms and a lower quality of life, alongside an increased likelihood of depression, anxiety, hyperactivity, inattention, and difficulty processing information​​.

Given the potential for misdiagnosis and the profound impact of sleep quality on a child’s well-being, it’s crucial for parents and healthcare providers to be aware of the connection between ADHD and sleep disorders. Proper evaluation and treatment can 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 result in 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 instances, addressing SDB can lead to such significant improvements that a child no longer meets the criteria for an ADHD diagnosis​​.

For younger children who are still in their growth phase, the application of a dental device known as a palatal expander has been shown to be beneficial. 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, potentially alleviating some breathing-related sleep issues.

For older children whose growth has ceased, Oral Appliance Therapy (OAT) might offer relief. OAT utilizes a tailor-made dental appliance that adjusts the jaw’s position during sleep, ensuring the tongue does not block the airway, thereby minimizing the risk of sleep disruptions. There are other ways to treat sleep disorders in older children; we discuss this below.

The initial step towards 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 You Child

Our sleep specialist in Mansfield is an excellent starting point for addressing mouth-breathing concerns because we are skilled in 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, and can also refer you to other specialists, like allergists or ENT doctors, for comprehensive care. Our familiarity with your child’s oral health history makes us well-positioned to detect and address these issues early. Dr. Jung has also undergone specialized further 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 DEKA QuiteNite laser can be used in various ways to help treat sleep disorders in children. This is done by tightening areas in the mouth that could limit airflow, which causes snoring. This is a painless procedure.
  • Oral Appliance Therapy: Most of our young patients benefit a great deal 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 & 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: Educating 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 are overmedicated for a problem that has an underlying cause. If your child is struggling with ADHD or sleep disorder, give our office a call, and we will be happy to help you find a solution!