ADHD and Sleep Apnea

[ChicagoGranny]

Parents, prepare yourself for some all caps yelling, because this is going to change some lives. All parents. If you have a child, I'm going to tell you something you need to know that you have probably never heard. And please share this. There is a huge red flag in the picture I am sharing with this story. Do you see it?

CHILDREN SHOULD NOT BREATHE THROUGH THEIR MOUTHS. Not while awake, not while asleep. Never.

If your child:
falls asleep immediately after their head hits the pillow,
snores,
grinds their teeth,
wakes up in the night,
has night time accidents or daytime accidents,
has impulse control issues,
is hard to understand when speaking,
has under eye circles
has crooked teeth or a misaligned bite,
wakes up insanely early,
is irritable during the day,
has a bad appetite,

Let me back it up to last year: My son, Kian, now age 8, determined, intelligent, feisty, and extremely active. He started school, no problems in Kindergarten. First grade rolled around, and we started getting behavior reports. "Kian pushed so and so" "Kian is having a hard time controlling his body" . Parent teacher conferences, new reward system in place, and it seems to improve. But at home it did anything but. When Kian gets angry, he gets ANGRY. He gets fixated on little things (there is a hair in the shower, it's gross! I can't shower in there! *melt down commences*), his fuse gets shorter and shorter, and he's a picky eater who barely eats.

Second grade rolls around, and oh boy. While other kids are outgrowing their tantrums, Kian's intensify and turn into daily spectacles, triggered by the smallest thing. The behavior reports from school start rolling in. "Kian is pushing" "Kian can't control his impulses" "Kian is having a hard time staying in his seat" and it going on and on. Almost daily. And I'm mortified. Every morning it's tantrum after tantrum, before we even get out of bed. Hitting, and throwing things, and the screaming. All the screaming. Starting at 5AM every morning. We were at a loss - how did he become this way, what could be have done different?

Kian starts seeing a therapist, recommended by his pediatrician. The therapist starts working with him, and eventually recommends ADHD testing. Meanwhile, in the background, Kian has a persistent cough that just won't go away, so we are also seeing a pulmonologist, and, against the advise of the pulmonologist, an allergist. This will become relevant in a moment. Each doctor is recommending more and more medications - 2 inhalers for the cough, an antibiotic (4 different rounds) for the postnasal drip, a steroid, and it goes on and on. The therapist is dancing around ADHD, pushing us in that direction. At a cleaning, Kian's dentist makes an offhand comment about his teeth - they were ground almost half way down, he's grinding his teeth at night.

And then lightening struck, right at the perfect time. I stumbled upon an article that changed our life. The article, I'll include in comments, was about the connection between ADHD, sleep disordered breathing, and mouth breathing. Every word in this article sounded like Kian. This led me down a rabbit hole of research (the majority of which was done right in our back yard at the National Institute of Health) where I learned the following:

-Mouth breathing is NOT NORMAL and has long term consequences for health. I'll repeat, because this is important - MOUTH BREATHING IS NOT NORMAL, NOT DURING THE DAY OR AT NIGHT. When a child breathes through their mouth, their brain (and body) is not getting enough oxygen. At night, this lowered oxygen saturation is detrimental to the quality of sleep and their brain's ability to get enough rest.
-When the mouth is open, the tongue cannot rest in the correct place. Over time this can lead to incorrect development of the upper jaw - narrow and high palette, a recessed lower jaw (overjet and overbite can form), speech problems (r/l mispronunciation) and misaligned teeth. These developments narrow the airways and worsen the problem. Medical professionals have a term for the resulting 'long' face caused by these changes - 'Adenoid face.'
-When sleeping, in addition to the decreased oxygen, the recessed jaw can cut off the airway completely and contribute to sleep apnea in children. To compensate, the body wakes the child and pushes the jaw forward, resulting in disrupted sleep cycles and tooth grinding (bruxism).

Here's the kicker:
-Sleep deprivation in children and ADHD exhibit the same symptoms. The EXACT SAME SYMPTOMS. Studies have been done (thanks, NIH) where they took medicated ADHD kids, fixed the sleep disordered breathing, and within 6 months 70% of the children had seen a resolution in symptoms and were no longer medicated. As in, their 'ADHD' was cured. Because it wasn't ADHD. In 70% of children. Let that sink in. This means that 70% of those children had been misdiagnosed with ADHD, when they actually had a treatable sleep disorder.
-Stimulants - Of course they work, until they don't. If you are sleep deprived, taking a stimulant will of course help you focus and feel 'normal.' But the brain is never fully resting - and hence the side effects that pop up '
nervousness,
agitation,
anxiety,
sleep problems (insomnia),
stomach pain,
loss of appetite,
weight loss,
nausea,
suicial ideation'
Imagine yourself with, let's say, three days of sleep deprivation. How multiply that times 100. Now throw a stimulant in the mix. How do you think you'll feel once you start coming down from that?
The list goes on and on (I am happy to share, message me if you want to know more).

Our story has a happy ending.

After a visit to an ENT and a sleep study he was diagnosed with sleep apnea and sinusitis. He got exactly 0 minutes of REM sleep during the first study, and oxygen saturation in the low 80%, and his sinuses were 90% blocked. We had no idea that Kian had a headache daily, but it was just his normal so he never thought to tell us. Kian had his tonsils and adenoids removed and the change was immediate. He could breathe through his nose as he came out of surgery, where he couldn't when they wheeled him in.

We have seen a complete 180 in behavior. No more angry tantrums, no more fixation on little OCD things, it's been an enormous change. And we haven't even finished the second step - fixing his jaw and tongue issues that developed during the course of undiagnosed sleep apnea. Our followup sleep study? 360 minutes of REM sleep, and oxygen saturation above the minimum threshold. No behavior reports in school. His appetite has exploded, hes no longer a picky eater, and he had a huge growth spurt 2 weeks after the surgery. He still has mild sleep apnea, but the frequency in the night was cut in half, and the duration of each episode was cut in half. If we see this much of a change now, I can only imagine how much it will improve once we cross the finish line.

Here's why I am sharing: No one, in my 12 years of parenting, ever told me any of this. All the signs were there, right in front of our eyes, and I had no clue. Kian's pediatrician, who we loved and trusted, never said a word. The therapist had no clue, the pulmonologist, the allergist, even the ENT and sleep doctor didn't believe me when I insisted he be seen for this invisible health issue. Not during any of our regular appointments, or during any of our sick child appointments. And not until we have tangible proof with sleep study results and sinus imaging did anyone believe. I had to find this, diagnose this, and push for treatment myself. And thank God I did.

If any of this is raising red flags in your mind, if this sounds like your child, if your child has been diagnosed with ADHD, please see an ENT and get a sleep study. It may just change your life.

Please share this, you may help someone - I wish I had learned this information years ago!

https://www.washingtonpost.com/…/could- ... -type-of-s…/

And if you want the research behind it, this is the tip of the iceberg:


- Melody Yazdani on a Facebook public post, https://www.facebook.com/melody.yazdani ... 8947832845

Melody's citations are in her FB post.

[CPAPSteve]

Wow nuts. I showed my spouse this article and we will be taking our child in for a sleep study. Melody’s story closely describes our child’s symptoms and I can’t help but wonder if it is the same underlying issue.

[Gryphon]

I'd recommend pinning this.

My childhood was like this as well. Lots of meds and people trying to help but no one had a clue.

You can also add to the list of symptoms...

if your child has
night terrors and or
reoccurring nightmares

This could also be a sign of a breathing related sleep disorder.

Restwell,

Gryphon

[nicholasjh1]

speech problems (r/l mispronunciation) .... Oh boy

[Gryphon]

speech problems (r/l mispronunciation) .... Oh boy

I could see how some of the specifics might not apply to all instances and may even be a bit of a streach... but overall. I think most kids who are diagnosed with ADHD should also have some sort of comprehensive workup to rule out sleep disorders before jacking them up on loads of meds...

not only did my struggles with meds continue through school but also on into adult hood were I had mental health professionals demand I take meds they gave me with out listening to any of my problems... I think I'm going to die in my sleep and I'm exhausted all the time. You think that could be a contributing factor to my depression? Well talk about it after you've been taking the meds I prescribed you... but but... I can't remember my own name let alone to take more pills.... I can't see you as a patient if you won't try... ugggg. Bangs head on desk.

[ChicagoGranny]

I think most kids who are diagnosed with ADHD should also have some sort of comprehensive workup to rule out sleep disorders before jacking them up on loads of meds...

Amen!

Too many kids are being given powerful, mind-altering drugs. This is the wrong treatment.

So sorry the medical profession put you through those awful times.

[nicholasjh1]

speech problems (r/l mispronunciation) .... Oh boy

I could see how some of the specifics might not apply to all instances and may even be a bit of a streach... but overall. I think most kids who are diagnosed with ADHD should also have some sort of comprehensive workup to rule out sleep disorders before jacking them up on loads of meds...

not only did my struggles with meds continue through school but also on into adult hood were I had mental health professionals demand I take meds they gave me with out listening to any of my problems... I think I'm going to die in my sleep and I'm exhausted all the time. You think that could be a contributing factor to my depression? Well talk about it after you've been taking the meds I prescribed you... but but... I can't remember my own name let alone to take more pills.... I can't see you as a patient if you won't try... ugggg. Bangs head on desk.

I was saying that because my Daughter is 7 and has a lot of these symptoms, including the R/L mispronunciation... that one really stuck out. I ordered an oxygen monitor that can monitor overnight (for at least one night anyway without replacing the battery.) which should hopefully be enough to determine if there's an issue, since it sounds like there might not necessarily be snoring in kids (it mentions shallow breathing etc). I should get it tomorrow.

[ChicagoGranny]

I was saying that because my Daughter is 7 and has a lot of these symptoms, including the R/L mispronunciation... that one really stuck out.

Thanks for the clarification.

I hope you persist in evaluating your daughter's condition. Just remember, false negatives are a problem - you can have a normal pulse-ox study and still have SDB.

[Gryphon]

I was saying that because my Daughter is 7 and has a lot of these symptoms, including the R/L mispronunciation... that one really stuck out. I ordered an oxygen monitor that can monitor overnight (for at least one night anyway without replacing the battery.) which should hopefully be enough to determine if there's an issue, since it sounds like there might not necessarily be snoring in kids (it mentions shallow breathing etc). I should get it tomorrow.
[/quote]

Oooh - sorry about that. I saw the "O boy" and interpreted that more as an exasperated eye roll - not as a "O boy, I need to really get on that"

I didn't snore when I was a kid - though I did have night terrors, reoccurring horrible dreams, and a lot of the other symptoms that were listed in the first post.

Growing up my child hood and young adult hood were marked by my parents lovingly going to bat for me, with Doctors who were trying to help but kept throwing chemicals at me to try and "Fix me" with a pill... No one knew to look for sleep apnea at the time. Though later in my 20's I think I also got stuck with a few head headshrinkers who were just stuck on auto pilot - and saw me as a way to make up a visit slot in their roster. I had one doctor who argued with me and refused to talk to me about much of anything pertinent until after I was consistent in taking "Zoloft" which wasn't doing a darn thing. He fired "Me as a patient" because I wouldn't cooperate and take my medicine. I'm still a bit bitter about that, as at the time I was in a really low point in my life and it would have been nice to talk to a mental health professional with out the feeling of condescension and like I was wasting his time. I left still not knowing what could be wrong with me and not feeling so good about my prospects.

Years later after finally treating my Apnea - I still have ADHD/Hyper Active... Issues. So my new general doctor has been listening and working with me to try and help... He doesn't do sleep medicine but I've mostly got that covered at this point. One of the meds he tried with me was once again good'ole "Zoloft" after taking it for like 3 months... And being able to think and evaluate my body with a clear head. I was able to figure out, I'm one of the few people who's mildly allergic to it, or that it gives me bad side-effects, IE: multiple migraines a week, and profuse sweating when ever I got even a little overheated, So that was fun, did I mention my doctor started me out on Zoloft in the summer and my car's AC system died the year before? Fun times!!! LOL...

If I had been taking it regularly years earlier and started getting 3+ migraines a week I'm not exactly sure I'd still be around to be here hanging out in this discussion group with all of you wonderful people.

Here's hoping that more knowledge spreads to all the people who need it so less people have to struggle with sleep disorders not knowing what to do.

Rest well,

Gryphon

[prodigyplace]

My wife who was trained as a Special Education teacher says the symptoms described are not the normal symptoms they were trained to look for to suggest ADHD, but rather, just point to some other sort of health problem.
That doesn't mean he wasn't (mis)diagnosed with it, though. Temper tantrums are not usually associated with ADHD. Sometimes, due to sinus health issues, short term breathing through the mouth is actually recommended.

[SirGaspAlot]

This is really good. We are raising our Grand daughter and she exhibits a whole lot of these symptoms. Along with being a premie (she weighed 3.4 lbs at emergency C-section for not getting oxygen) I'm really thinking were on to something here very important for her. Thank you for this.

[ChicagoGranny]

I'm really thinking were on to something here very important for her.

How old is she? What's your next step?

BTW, LSAT found this made Yahoo news - https://www.yahoo.com/lifestyle/mom-rea ... 25821.html

[SirGaspAlot]

Removed, typing on a phone isnt cooperating

[SirGaspAlot]

She is 7. She is a premie due to drug abuse, wasnt getting enough oxygen in the womb, was revived at birth and weve had her ever since, partly also because of shaken baby syndrome (her mother again). The huge hint here to me, is up until being given medicines, she rarely slept at all. I'd get up for work at 5 am to find her sitting in the couch, not roudy or hyper, just awake, and often she'd be up around the clock again. We didnt get a single nights sleep. She has hostile days where she wants you to understand something shes saying but we cant because her speech isnt clear and she loses it and starts hitting and squeezing my wife's arm. We had an EEG done to test her signals but she was awake. Theyve never been able to get a good one while asleep. I definitely want to do that now that I see this.

I'm really thinking were on to something here very important for her.

How old is she? What's your next step?

BTW, LSAT found this made Yahoo news - https://www.yahoo.com/lifestyle/mom-rea ... 25821.html

[dreamingofdreaming]

My daughter always had a very nasal sound to her voice and started snoring very loudly when she was 7-8. I mentioned that to her pediatrician, who sent us to see an ENT doc. He took one look at her and scheduled her for surgery. Her adenoids were so big, they were completely blocking her nasal passage. After that, no more snoring and she sleeps so much better.