It seems that attention deficit hyperactivity disorder (ADHD) is a common diagnosis for many children these days. Kids with ADHD are seen to be hyperactive and unable to control their emotions. But are we too hasty to diagnose kids with this condition? One mum recently found out that toddler sleep apnea can easily be misdiagnosed as ADHD.
Son’s “ADHD” was toddler sleep apnea
Melody Yadzani, an American mum, is urging parents to be cautious of sleep apnea symptoms in kids following her son’s near misdiagnosis of ADHD.
She details her experience in a Facebook post, which has now spread virally. In the post, she talks about how her son, Kian, aged 8, had behavioural problems in Primary one.
While his behaviour at school improved, it remained the same when he was at home. She describes her son’s symptoms chronologically:
During primary one, Kian…
- Has a MASSIVE tantrum if he becomes angry
- Was obsessed by trivial things – say, a hair strand in the shower, which can lead him to refuse showering and melt down
- Becomes easily annoyed and angry
- Hardly eats anything due to his pickiness.
In Primary two, Kian…
- has tantrums that worsened. He explodes over tiny matters, unlike his peers who are outgrowing their anger. Yadzani says she receives behaviour reports from school every day.
- wakes everyone up through his tantrums – as early as 5am, every day. He hits things, flings them around and shouts a lot.
After bringing him to a therapist, the medical professional suggested him to be evaluated for ADHD. In the meantime, Kian also suffered from a chronic cough, so Yadzani also brought him to a pulmonologist, who also referred him to an allergist.
A visit to the dentist also showed that boy’s teeth were worn down. Apparently, he had been grinding his teeth at night.
One of the symptoms of toddler sleep apnea is that your child throws off a massive tantrum at home and school. | Image source: iStock
Miracle article turn around family’s life
However, it was only after Yadzani saw read through a piece from the Washington Post that everything “clicked into place” and “changed our life”.
The article elaborated on how ADHD, sleep-disordered breathing, and mouth breathing were all linked. “Every word in this article sounded like Kian,” she wrote.
Yadzani initially did suspect something was affecting Kian’s sleep. Not only was he unable to control his tantrums, but he had dark circles below his eyes.
A “180 degree” change
After her revelation, the mum “immediately” fixed appointments with multiple specialists: a paediatrician specialising in the ear, nose, and throat, an orthodontist, and also a sleep clinic.
At first the medical staff were doubtful of the mum’s claims, but they did provide a sinus imaging and sleep study to check if anything was wrong.
Shockingly, through these tests, Yazdani discovered that all of Kian’s were plugged up and inflamed. The sleep study also pointed that something was wrong: Kian didn’t receive any REM sleep (deep sleep) in the first study, with very low oxygen saturation.
Apparently, Kian also experienced headaches every day. But he thought it was normal so he didn’t inform the parents of the issue.
Once doctors removed Kian’s tonsils and adenoids, there was an instant difference in his behaviour. To summarise, he:
- could now inhale from his nose after the procedure, but he couldn’t before entering the Operating Theatre
- doesn’t explode into any more angry tantrums,
- doesn’t obsess on trivial matters
- has a voracious appetite
- isn’t so picky with food
- had a massive growth spurt 14 days post surgery.
That isn’t considering his other jaw and tongue problems. Furthermore, his next sleep study produced good results: six hours of REM sleep, with oxygen saturation over the minimal benchmark.
Clearly, Kian now doesn’t get any more behavior reports from school. Even though he has mild sleep apnea, it’s now manageable.
Check out the more on the mum’s original Facebook Post below:
If your child has been diagnosed with ADHD, check on a sleep study first
Looking back, Yazdani says the red flags were all there: mouth-breathing, ADHD symptoms, tooth grinding, dark circles below his eyes, and snoring.
She stresses that these signs are“not normal and need to be addressed by a professional”, urging parents to “insist on a sleep study if they are discussing a possible ADHD diagnosis.”
W. Christopher Winter, a board-certified sleep medicine doctor and neurologist, echoes Yazdani’s advice. He says that “no child should be diagnosed with ADHD unless they’ve had some kind of sleep evaluation.” After all, “Anything that affects a child’s sleep is going to create sleepiness the next day,” says the writer of The Sleep Solution: Why Your Sleep Is Broken and How To Fix It
In fact, says Winter, kids display sleepiness in a different way compared to adults. Instead of appearing drowsy or nodding off, kids will behave in a hyperactive manner and find ways to combat it. “A lot of them are very inattentive and misbehave.” Children with a diagnosis of ADHD are also usually given a drug called Adderall, which might cover up symptoms of sleepiness – not treating the real cause.
One of the telltale signs of toddler sleep apnea is your child snoring. | Image Source: Stock Photo
Other signs of toddler sleep apnea, according to a medical expert
However, Winter partially disagrees with Yazdani’s comments, which indicate that kids should be forbidden from breathing using their mouths. “It’s not bad for them to breathe through their mouths, but it could be a sign of something bad,” he says.
Instead, the professional advises parents to watch out if their child snores, gets behavioral reports from school, finds themselves awakening often at night, and wets the bed. These are all subtle hints that your child has sleep apnea.
So parents, the take-away message is that if your child seems to have ADHD but you think that toddler sleep apnea could be the reason for their behaviour, discuss about getting a sleep study with your pediatrician. “A sleep study is easy, and it could be a game changer,” says Winter.
References: Yahoo News
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