Post by laurasnowbird on Apr 30, 2006 20:54:25 GMT -5
Okay, I’ve been doing lots of looking into the link between sleep disorders and ADHD.
Some thoughts:
First and foremost, don’t start second guessing yourself and faulting yourself for not thinking of this. You AREN’T the doctor, and that is why we take our kids to doctors. Your behavioral doctors may have already ruled this out? But most likely they haven’t if you don’t recall them questioning you closely about his sleep habits.
The reason that I was watching for this is because when Ethan was six weeks old he had RSV pneumonia and Dr. Zureikat, who treated him in the ICU told me about the high incidence of sleep apnea in children with DS and instructed me what to watch for. Even knowing that, Ethan seemed to be such a good sleeper and never snored, so I didn’t take a REALLY close look at his sleep habits until he crashed that night.
I did see some reference to ADHD medications actually causing disordered sleep. So that is a factor to keep in mind. However, a sleep study would reveal apneas, whether they were central (caused by the brain) or obstructive (caused by partial airway collapse (OSA). Your pediatrician should be able to refer you for a sleep study. I would start there, because if there’s no apnea, there should be no need to see the ENT.
You mentioned that Chase had his tonsils removed, and that is usually the first thing they suggest for people with OSA. I was intrigued to learn when I was looking this stuff up that the tonsils and adenoids can re-grow. Freaky, huh? If it turns out he has sleep apnea, and his tonsils and/or adenoids are not the problem, there are still other treatments available.
I don’t know if you have a sleep lab near you, but you are pretty close to me, and the guy who runs the sleep lab down here is the same guy who saw Ethan in the ICU years ago, Dr. Zureikat.
Anyway, I was surprised at the number of references to ADHD and sleep disorders, such as this “Overall, sleep deprivation can result in mood changes, inattention, delayed reaction time and impaired vigilance, decreased motivation, hyperactivity, aggressive behavior, and impulsivity. These symptoms overlap with those commonly associated with ADHD”.
From the New York Times, April 4, 2006
Researchers have found strong evidence that adenotonsillectomy — the surgery to remove the tonsils and adenoids — can help relieve childhood behavioral or attention problems, including attention-deficit hyperactivity disorder, or A.D.H.D.
"A.D.H.D. probably has many different causes in different people," Dr. Chervin said. But in some cases, he continued, an undiagnosed sleep disorder could be the problem. "It's certainly worth bringing this up with a pediatrician," he said. "My guess is that treating an underlying sleep disorder could end up helping a significant minority of children with A.D.H.D."
The doctor quoted in this article was the lead researcher on the recently published paper, and he is in Michigan at U of M. (neurology department)
From Dr. Greene’s site:
"Other common symptoms of sleep apnea include mouth breathing, restless sleep, difficulty paying attention during the day, decreased academic performance, oppositional behavior, and restlessness."
www.drgreene.com/21_1189.html
www.adda-sr.org/reading/Articles/Medication%20Corner/Tarnowadhdandsleepdisorders.htm
Some thoughts:
First and foremost, don’t start second guessing yourself and faulting yourself for not thinking of this. You AREN’T the doctor, and that is why we take our kids to doctors. Your behavioral doctors may have already ruled this out? But most likely they haven’t if you don’t recall them questioning you closely about his sleep habits.
The reason that I was watching for this is because when Ethan was six weeks old he had RSV pneumonia and Dr. Zureikat, who treated him in the ICU told me about the high incidence of sleep apnea in children with DS and instructed me what to watch for. Even knowing that, Ethan seemed to be such a good sleeper and never snored, so I didn’t take a REALLY close look at his sleep habits until he crashed that night.
I did see some reference to ADHD medications actually causing disordered sleep. So that is a factor to keep in mind. However, a sleep study would reveal apneas, whether they were central (caused by the brain) or obstructive (caused by partial airway collapse (OSA). Your pediatrician should be able to refer you for a sleep study. I would start there, because if there’s no apnea, there should be no need to see the ENT.
You mentioned that Chase had his tonsils removed, and that is usually the first thing they suggest for people with OSA. I was intrigued to learn when I was looking this stuff up that the tonsils and adenoids can re-grow. Freaky, huh? If it turns out he has sleep apnea, and his tonsils and/or adenoids are not the problem, there are still other treatments available.
I don’t know if you have a sleep lab near you, but you are pretty close to me, and the guy who runs the sleep lab down here is the same guy who saw Ethan in the ICU years ago, Dr. Zureikat.
Anyway, I was surprised at the number of references to ADHD and sleep disorders, such as this “Overall, sleep deprivation can result in mood changes, inattention, delayed reaction time and impaired vigilance, decreased motivation, hyperactivity, aggressive behavior, and impulsivity. These symptoms overlap with those commonly associated with ADHD”.
From the New York Times, April 4, 2006
Researchers have found strong evidence that adenotonsillectomy — the surgery to remove the tonsils and adenoids — can help relieve childhood behavioral or attention problems, including attention-deficit hyperactivity disorder, or A.D.H.D.
"A.D.H.D. probably has many different causes in different people," Dr. Chervin said. But in some cases, he continued, an undiagnosed sleep disorder could be the problem. "It's certainly worth bringing this up with a pediatrician," he said. "My guess is that treating an underlying sleep disorder could end up helping a significant minority of children with A.D.H.D."
The doctor quoted in this article was the lead researcher on the recently published paper, and he is in Michigan at U of M. (neurology department)
From Dr. Greene’s site:
"Other common symptoms of sleep apnea include mouth breathing, restless sleep, difficulty paying attention during the day, decreased academic performance, oppositional behavior, and restlessness."
www.drgreene.com/21_1189.html
www.adda-sr.org/reading/Articles/Medication%20Corner/Tarnowadhdandsleepdisorders.htm