According to Dr. Stephen H. Sheldon, North-western University, USA, and director of the largest children’s sleep clinic in the USA, “There is no such thing as ADHD, these kids are simply trying to stay awake.”
We all know how children behave when they are tired. When on holiday have you observed young children who were kept up far too late by their parents? They display the sort of behaviour that you may have described as ‘hyperactive’. Imagine how these children would behave if they never had a good nights’ sleep.
Key point. Children don’t know that they are having problems sleeping.
It is up to the parent to recognise that there is a problem. Have you ever moaned about your child forgetting to do simple tasks or chores? This is a classic example of Sleep Disordered Breathing (SDB). Have a listen if they are snoring or look to see if they have their mouth open when sleeping.
ADHD and SDB are completely different issues but both present similar signs and symptoms in children. Making a misdiagnosis in a child will have a big short-term negative effect and could have consequences that may affect them for the rest of their life.
The drug commonly prescribed for ADHD is Ritalin. Nearly 3 billion doses of this drug have been consumed. The side effects of Ritalin are:
Trouble sleeping
Nervousness
Loss of apatite
Vomiting
Headaches
What do you think would be the outcome if a drug that prevented sleeping was administered to a child with SDB?
So, what are the effects of SDB in children apart from being permanently tired, irritable, and unable to concentrate? If children are not breathing correctly at night, for example, snoring or mouth breathing, they commonly fail to get into a deep sleep, termed slow-wave sleep, and spend the night having many small sleeps. Human growth hormone is released during slow-wave sleep and this hormone is responsible for the growth and development of the child. Reduction in human growth hormone due to SDB will prevent the child from developing as they should.
The specialist responsible for making an ADHD or SDB diagnosis should be the paediatrician, so could a paediatrician differentiate between sleep disorders and ADHD? The answer to this question is mostly no. In a study of the members of the American Academy of Paediatrics which looked at sleep screening practices amongst paediatricians, researchers discovered that fewer than one in five had received any training in sleep disorders (1).
The sooner that an SDB diagnosis is made, the better. This can only be done by having a sleep study. This is the only way to differentiate between SDB and ADHD.
Doctor Karen Bonuck researched 11,000 snoring kids and studied them at 6, 18, 30, 42, 54, and 69 months. Children who had peak SDB symptoms before 18 months that resolved still predicted 50% increased odds of behaviour problems at 7 years. (2) Snoring in babies is not cute and should be addressed immediately.
If you would like to discover more about breathing and how it can affect babies, children, and adults, we have a great on-line course that is available here: LipZip
If you are a healthcare professional and would like to learn more, I am presenting live online courses with continuing education points. Information here: Courses
- Faruqui, F., et al. Sleep disorders in children: a national assessment of primary care paediatrician practices and perceptions. Paediatrics. 2011. https://pediatrics.aappublications.org/content/128/3/539
- Bonuck, K., et al. Sleep-disordered breathing in a population-based cohort: behavioural outcomes at 4 and 7 years. Paediatrics 2012; 129: 1-9.