Kids and sleep disorders

DeltaSeeker · Post by **DeltaSeeker** » Wed Jun 13, 2007 9:01 pm

My twins (boy and girl) were both diagnosed with ADHD and my daughter with cognitive disorder, math disability, and reading disability as well. I read somewhere that a lot of times ADHD and other problems can be misdiagnosed when they are actually sleep disorders. My son sometimes snores, but quite often he sleep walks. It's quite strange to see him doing it. It's like his body's there but no lights are on upstairs. I just redirect him to bed unless I'm asleep and I find him in my bed. My daughter often has night terrors. Wakes up screaming and crying, talking incomprehensively and can't tell us what's wrong. Once I get her calmed down, she goes right back to sleep. I know a lot of this can be normal at their age (8) and can resolve itself. I'm just wonder if it's causing sleep deprivation and therefore causing some of the ADHD and other symptoms... Any comments and/or experience???

tiredofbeingsleepy · Post by **tiredofbeingsleepy** » Wed Jun 13, 2007 9:18 pm

I just read an article today online that said there are many children who are diagnosed with ADHD who actually may have sleep apnea instead. Some of their symptoms (inattention for example) are similiar.

I also read one online (at webmd.com, I think - do a search there on sleep apnea in children) that had a drawing of an open mouth that showed the uvula and tonsils - it explained that enlarged tonsils in children predisposes them to having sleep apnea and how T&As (tonsillectomy and adnoidectomy) often helps to resolve OSA.

Anyway, interesting that you posted this question when I was reading up on it today!
Do a google search on sleep apnea in children - there were many articles listed. I'll try to find the ones I was talking about and post a link if I'm successful.

How old are your twins? My youngest had terrible night terrors until he was about 3 or 4. It was aweful - I had never seen anything like it before.
It would be interesting to know if kids who have night terrors, enlarged tonsils, and some attentional issues as kids eventually end up having OSA......

tiredofbeingsleepy · Post by **tiredofbeingsleepy** » Wed Jun 13, 2007 9:26 pm

Here is the article with the diagram of the throat:
http://www.aafp.org/afp/20040301/1147.html

Here's another good one at drgreene.org :
http://www.drgreene.org/body.cfm?xyzpdq ... il&ref=621

DeltaSeeker · Post by **DeltaSeeker** » Wed Jun 13, 2007 9:26 pm

Oh yeah, I forgot to mention that both of my kids have really swollen tonsils. They almost touch in the back. The doctor has commented before on how large their tonsils are...

DeltaSeeker · Post by **DeltaSeeker** » Wed Jun 13, 2007 9:27 pm

P.S., Tired - my kids are 8.

DeltaSeeker · Post by **DeltaSeeker** » Wed Jun 13, 2007 9:32 pm

Funny too - I just noticed the link at the top of the page. Here's the article... BTW, my kids do follow a pretty strict bedtime routine and I make sure they get enough sleep at night, so that rules out sleep hygiene. But they still mentioned other sleep disorders can contribute. Actually the kids they describe sound exactly like mine..... Guess it's off to the doc!

Public release date: 13-Jun-2007
[ Print Article | E-mail Article | Close Window ]

Contact: Jim Arcuri
jarcuri@aasmnet.org
708-492-0930
American Academy of Sleep Medicine

Poor sleep hygiene in children associated with behavioral problems
WESTCHESTER, Ill. – A research abstract that will be presented Wednesday at SLEEP 2007, the 21st Annual Meeting of the Associated Professional Sleep Societies (APSS) finds that a snoring child's poor sleep hygiene habits can have a negative influence on his or her daytime behavior.

Lisa Witcher of the University of Louisville, who authored the study, interviewed the parents of 52 children between the ages of five and eight who were reported to snore "frequently" to "almost always". The children underwent an overnight polysomnography, and parents were asked to complete the Children's Sleep Hygiene Scale (CSHS) and the Conners' Parent Rating Scales-Revised (CPRS-R).

The results showed strong negative correlations between the CSHS overall sleep hygiene score and CPRS-R total externalizing behaviors. The CSHS total was also negatively correlated with the CPRS-R cognitive/inattention problems, hyperactivity, perfectionism, ADHD index, and restless and impulsivity total scores among others. Further, the CSHS physiological, cognitive, emotional, environmental, and bedtime routine subscales were also significantly negatively correlated with externalizing behaviors on the CPRS-R.

"The parental reports indicate poorer sleep hygiene is associated with both internalizing and externalizing behavior problems, specifically those associated with ADHD symptoms," said Witcher. "While no causation can be inferred, an overlap between daytime behavior problems, poor sleep hygiene, and potentially problematic bedtime behaviors in snoring children may exist and deserves further study."

Snoring is a sound made in the upper airway of your throat as you sleep. It normally occurs as you breathe in air. It has been found in all age groups. Between 10-12 percent of children are found to snore. Almost everyone is likely to snore at one time or another.

Snoring can, however, be indicative of a more serious condition, namely, obstructive sleep apnea (OSA), which refers to a sleep-related breathing disorder that causes one's body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway, which prevents air from getting into the lungs.

Parents who suspect that their child might be suffering from OSA, or another sleep disorder, are encouraged to consult with their child's pediatrician, who will refer them to a sleep specialist.

Children should follow these steps to get a good night's sleep:

Follow a consistent bedtime routine.

Establish a relaxing setting at bedtime.

Get a full night's sleep every night.

Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.

Do not go to bed hungry, but don't eat a big meal before bedtime either.

The bedroom should be quiet, dark and a little bit cool.

Get up at the same time every morning.

###
Experts recommend that children in pre-school sleep between 11-13 hours a night, and school-aged children between 10-11 hours of sleep a night.

The annual SLEEP meeting brings together an international body of 5,000 leading researchers and clinicians in the field of sleep medicine to present and discuss new findings and medical developments related to sleep and sleep disorders.

More than 1,000 research abstracts will be presented at the SLEEP meeting, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The four-day scientific meeting will bring to light new findings that enhance the understanding of the processes of sleep and aid the diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.

tiredofbeingsleepy · Post by **tiredofbeingsleepy** » Wed Jun 13, 2007 10:51 pm

Actually the kids they describe sound exactly like mine..... Guess it's off to the doc!

It sounds like that might be a good idea! I would suggest bringing copies of those articles with you - or better yet, send them to the office prior to their appointment so he/she can read them. There are many MDs out there who don't know a whole lot about sleep apnea and I would assume there are even more who don't know much about sleep apnea in children.

It is an interesting subject! It makes me wonder if some of these kiddos at school are properly diagnosed. Obviously there is ADHD/ADD, but there could be kids out there who have sleep apnea instead.

There is another member here who has posted and has a 4 year old with sleep apnea on CPAP. Hopefully she will read this thread and post!

Good luck with your kiddos!

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

Wistful · Post by **Wistful** » Thu Jun 14, 2007 5:40 am

I would definitely get them off to the Doc - you have apnea, they have sleep related symptoms and large tonsils - If nothing else it will put your mind at ease and may solve a lot of issues in the long run.

I had my son tested when he was 4, they sent the equiptment home. The first time it was just one little machine, the second, a nurse came with a whole set up. My son thought it was really cool.

Good luck!
W

HeatherN · Post by **HeatherN** » Thu Jun 14, 2007 5:58 am

My daughter is eight and has sleep apnea. I suspect she has had it for years but we finally were diagnosed when she was seven. She had all the classic symptoms. She has a lot of other health issues so our situation is different but that being said she did have some behaviours that we considered maybe an ADD situation. A lot of her bahaviour makes sense now-she is exhausted!She also had night nerrors as a toddler.I wonder if there is a hereditary connection as her Dad also has apnea and I do some weird things in my sleep too.I had a hard time getting a DR to take me seriously then found a great ENT who did and he referred us to a pediatric sleep DR. She has been on CPAP for three weeks and doing pretty well with it. She did have tonsil and adnoid surgery when she was four and it really did resolve the issue for a long time. In kids I know that is usually the first step.If they are having that many issues I would definitely request sleep studies, especially based on their learning issues, the fact that they have night terrors and sleepwalking and that their parent has apnea.It can't hurt to at least rule out the possibility. Any ENT that has any experience with kids should be able to set it up for you. BY the way, I thought there was no way Hannah would ever be able to handle CPAP and was beside myself when she was diagnosed- she is doing great with it , It really can work out fine.Keep us posted and let me know if I can help in any way.

socknitster · Post by **socknitster** » Thu Jun 14, 2007 7:37 am

I am concerned about this also because my son has had sleep issues since birth. He had reflux and was on reflux meds as an infant and was very sleep deprived until the infant reflux wore off and he started sleeping more peacefully.

Now it is on my mind because he is almost 4 and going thru the stage where he is giving up his afternoon nap. It is a natural progression at this age, but he is tired and cranky a lot even though we put him to bed at 7 and he sleeps about 12 hours at night. He even tries to take naps sometimes and will lay there for 1/2 an hour, very quiet, very good boy, just can't fall asleep!

Anyway, because it is on my mind I discussed it with my ent. He said in children, taking out tonsils and adenoids cures apnea in 90% of kids he sees, but in adults it is often much more complex.

As someone with big tonsils (mine also sometimes touch) I can say to you without a doubt--i would have your kids tonsils out! Tonsils that touch make you feel like you are gagging, not to mention what is happening when they are sleeping. They aren't doing them any good!

I'm going to schedule surgery to have mine out soon--I sure wish my parents had followed the docs recommendation to have mine out when I was a kid!

Good luck and keep us posted, DeltaSeeker! Get yourself some good expert opinions and I hope your kids feel better soon! If this solves the issue, they will bounce back fast, I'm sure!

Jen

DeltaSeeker · Post by **DeltaSeeker** » Thu Jun 14, 2007 3:36 pm

Thanks guys for all the responses. I have printed stuff out for my PCP before and faxed it to him prior to an apointment and not gotten any response. I'm concerned about my daughter as well because she always complains how much her feet hurt and I know she has pronation (heels wear out on the inside). But he was more concerned w/getting the ADHD and other issues under control before dealing with her feet

I have no doubt it would be fairly easy to get the kids to use CPAP. My son would just think of himself as Darth Vader. My daughter... hmm ... well, she could be just like mommy

My poor brother didn't have his tonsils out until he was in his 20's. It's so much worse as an adult. I felt so sorry for him. Good luck Jen with your surgery!

Unfortunately my PCP is listed under the AASM as a sleep doctor, but he didn't know that RLS can augment into the daytime??? Grrrr.... Seems like I have several more fights on my hands. Darn. No wonder I feel so drained so often...