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Sleep Apnea can Mimic Symptoms of ADHD

Posted Sep 16 2009 3:17pm

A recent study published in the medical journal, Pediatrics, in July 2009 found that one third of the 194 study subjects (who were age 4-10 years and had asthma) had Sleep Apnea (AKA  Sleep Disordered Breathing).  And these children also had significant behavioral problems when compared to those kids who did not have Sleep Apnea.

The authors suggest that pediatricians be "particularly diligent about screening all children with asthma for Sleep Disordered Breathing (Sleep Apnea) and also consider sleep disorders as a possible risk factor for behavior problems."

There is a growing body of evidence that sleep disturbances can cause and exacerbate behavior and learning problems and may mimic the symptoms of Attention Deficit Hyperactivity Disorder (ADHD).  It is important for pediatricians, psychiatrists and psychologists to consider sleep disorders early in the work up of ADHD (or other learning or psychiatric problems).  Indeed, I maintain that no child should receive a diagnosis of ADHD without having an overnight sleep study to rule out sleep apnea.

Parents with children diagnosed with ADHD can think that their children "sleep just fine" because they go to bed and seem to sleep for 10 hours before emerging from their bedrooms, but few parents sit and watch their children sleep for hours so they don't really know about their quality of sleep.  Too many children are being put on stimulates, and many at such a young age. 

These drugs were never tested in children and this usage is a recent enough phenomenon that we are only starting to see how people fare who have been taking stimulants (e.g. methylphenidate (Ritalin or Concerta); dextroamphetamine + amphetamine (Adderall);  lisdexamfetamine (Vyvance)  for many years.  I know that I see teens and young adults  every day in my sleep practice who suffer from intractable insomnia likely connected to lifelong use of prescription stimulants.

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