ADHD and Sleep Disorders

Does your child with ADHD toss and turn all night long? The reason might be a sleep disorder. In a recent study, researchers said that about half the parents in the study said their child with ADHD had difficulty sleeping. Parents reported that their child felt tired on awakening, had nightmares, or had other sleep problems such as sleep apnea or restless legs syndrome. Another study involving children with ADHD found the children had less refreshing sleep, difficulty getting up, and significantly more daytime sleepiness.

Sleep problems and ADHD seem to go hand-in-hand. Let's find out why.

Is snoring related to ADHD?

Large tonsils and adenoids can partially block the airway at night. This can cause snoring, poor sleep quality, and perhaps ADHD.

Because snoring can result in poor sleep, it may lead to attention problems the next day. A study involving 5- to 7-year-olds found that snoring is significantly more common among children with mild ADHD than it is in the general population. In another study, children who snored were almost twice as likely as their peers to have ADHD.

Children who snore perform significantly worse on tests of attention, language abilities, and overall intelligence.Some studies have shown that taking out the tonsils and adenoids may result in better sleep and improved behavior without the need for medications.

What is sleep apnea?

In simplest terms, apnea literally means without breathing. The word is used to describe an interruption of airflow of at least ten seconds. While there are three different kinds of apneas, the most common type is obstructive. Obstructive apnea makes up 65 percent of all apneas.

During obstructive sleep apnea, there is no airflow from the nose and mouth to the lungs. This is because the entrance to the trachea is completely blocked. The cause of the blockage is different structures in the pharynx that have collapsed. During this closure the respiratory muscles continue to make efforts to get air into the lungs.

People with sleep apnea have episodes of breathing cessation. They are aroused then from deep sleep to lighter stages of sleep. But they have these arousals while remaining completely unaware of the apneas or awakenings. These episodes can happen frequently throughout the night.

About 2% of kids in the U.S. have some form of obstructed breathing during sleep. Enlarged tonsils and adenoids are the most common causes of sleep apnea in children. But obesity and chronic allergies can also be a cause. As with adults, children with sleep apnea will be tired during the day. They may have problems concentrating and might have other symptoms related to lack of sleep. For instance, they may display irritability.

How is sleep apnea diagnosed and treated?

Sleep apnea in children is treatable. Yet only your pediatrician or an ear, nose, and throat specialist can determine whether your child's tonsils are enlarged enough to possibly block the airway and cause sleep apnea. Confirmation of sleep apnea should be determined by a polysomnogram. A polysomnogram is a sleep study that's done in a special laboratory. Not every child with enlarged tonsils or with loud snoring has sleep apnea.

Surgery is the treatment of choice for kids with enlarged tonsils and adenoids. Other treatments are available for those with restricted nighttime breathing due to allergies or other causes.