Is it ADHD, or does your child have sleep apnea?

Not much is understood by parents about snoring or sleep apnea, especially in their children. The Stanford School of Medicine states that about 10% of children 10 years of age and younger snore and, of those children who snore, about 20% will have obstructive sleep apnea.

Snoring can be a sign that your child has sleep apnea as it indicates, at the very least, that their airway is partially obstructed during sleep. Sleep apnea is a serious medical condition that can interrupt or stop your child's breathing, prevent a normal night's sleep, impair growth, and lead to a lower quality of life. It also can cause serious fatigue during the day which is why it is so often confused with ADHD.

Sleep-disordered breathing such as snoring and obstructive sleep apnea (OSA) have long been associated with ADHD (Attention Deficit Hyperactivity Disorder). You should know that not every child diagnosed with sleep apnea has ADHD, just as not every child diagnosed with ADHD has sleep apnea. However, many studies have been performed indicating a significant correlation between OSA and behavioral issues. Children with obstructive sleep apnea do not get restful sleep, and as a result may complain of morning headaches, be irritable and have difficulty concentrating.

Children with sleep apnea may complain of being tired during the day and, at the same time, exhibit hyperactive behavior or act impulsively. Herein lays the confusion of separating sleep apnea from ADHD because many of the classic symptoms of ADHD are often exhibited in children with OSA. So, as a parent of a child diagnosed with ADHD, what do you do?

It will be in your child's best interest if you dig a little deeper into the root of what may be causing these behaviors. Watch your child sleep at night - and even record it if you can. Check for restlessness, mouth breathing, snoring, or breathing pauses. If they occur, have your child evaluated for possible sleep apnea to ensure the proper diagnosis and treatment.

Figuring out if your child has sleep apnea or ADHD may seem quite complex but it doesn't have to be. Consult with a sleep apnea doctor if you can answer 'yes' to any or some of the following questions:

- Does your child snore?
- Does your child stop breathing for a few seconds at night?
- Does your child frequently mouth breathe?
- Does your child sleep through the night or is it a restless sleep?
- Is there frequent bedwetting?
- Does your child seem irritable during the day? Is there difficulty focusing? Are there periods of hyperactivity?

The good news is that sleep apnea is treatable. Enlarged tonsils and adenoids are the most common causes of sleep apnea in children. An Ear, Nose and Throat specialist can determine if your child's tonsils and adenoids are enlarged and possibly blocking the airway at night. A tonsillectomy and adenoidectomy can successfully treat sleep apnea by removing the obstruction in the airway resulting in a complete elimination of symptoms in 80-90% of children.

Dr. Lana B. Patitucci, D.O. is a Board Certified Otolaryngologist at The Pennsylvania Snoring and Sleep Institute. She is trained in all aspects of general and pediatric otolaryngology including endoscopic sinus, otologic, head and neck, and facial plastic surgery. Her hospital affiliations include Abington Surgical Center, Blue Bell, Chestnut Hill, Einstein Medical, Mercy Suburban, and Roxborough Memorial Hospital