there's more to it than you think...
If your child has been diagnosed with ADHD, like many parents you may be distraught with this diagnosis and looking for answers.
You may be surprised to know that there is a strong link between ADHD and paediatric sleep breathing disorders such as obstructive sleep apnoea (OSA). Paediatric OSA is a condition where the airway obstructs while your child is sleeping. This results in poor sleep quality and fragmented sleep.
A child suffering from OSA will exhibit signs such as:
- impaired cognitive development
- difficulty concentrating
- irritability and poor moods
- hyperactivity and impulsivity
This child is not getting good sleep. They are tired. As adults, when we are tired we understand the situation and may take some rest or take a nap. Children do not understand they need this so they remain restless in order to keep themselves awake. This restless can often be misdiagnosed as ADHD.
In the US, 6% of children are treated for ADHD and the diagnosis rate has increased by 42% from 2012 to 2020. Several studies show that 25% of ADHD diagnoses (some studies show up to 50%) in children are actually related to sleep breathing disorders. So if we can correct the sleep breathing disorder then quite often the child no longer fits the criteria for an ADHD diagnosis.
This study was a meta-analysis of man other studies, which makes it findings very reputable. It found that:
"The findings of this meta-analysis suggest that ADHD symptoms are related to SDB and improve after adenotonsillectomy. Therefore, patients with ADHD symptomatology should receive SDB screening. Treatment of comorbid SDB should be considered before medicating the ADHD symptoms if present."
It is paramount that all children in modern society are screened for airway obstructions.
By screening your child's airways, you could be saving your child from a misdiagnosis and also saving them from years of heavy drugs that will control mood but also increase the risk of other mental illnesses.
So what could be causing the sleep breathing disorder?
If your child has a sleep breathing disorder, it means they are struggling to breathe while they sleep. More often than not the obstruction in the airways originates from the nose. Things like enlarged turbinates, enlarged adenoids and a deviated nasal septum can impede nasal airflow so that your child is forced to breathe through their mouth most of the time. An excellent facebook page to follow is Dr David Mcintosh's.
"Mouth breathing" is not natural and has severe implications on the development of your child's face and jaw bones. More about there here.
The goal of an airway screening is to identify the source of an airway obstruction and take steps to:
- remove the obstruction
- correct any deficiencies in craniofacial development that resulted from the obstruction
- prevent any future issues
At The Dental Station, we take a wholistic approach to assessing your child. Before we even look at their teeth we'll be creating a comfortable environment for your child to feel confident in our chair. During this time we'll begin examining their face for signs of:
- asymmetry of the eyes, ears and cheek bones
- venous pooling under the eyes
- lip posture
- mouth breathing
- tongue posture and swallowing functions
- check the nose for enlarged turbinates
Once this is complete we'll look inside the mouth to assess
- teeth arch development
- jaw development
- signs of grinding
- check for enlarged tonsils
We also have a CBCT machine onsite which enables us to take 3D X-rays to assess your child's airway deep inside for signs of obstruction. Things like enlarged adenoids, inflamed maxillary sinuses are all captured on this X-ray.
We have all the tools in place to conduct a thorough assessment of your childs teeth and other systems. From these investigations we'll be able to formulate a comprehensive treatment plan that can include:
- airway focussed early intervention orthodontic treatment that focuses on developing the jaws correctly (without braces) to ensure there is sufficient space in the jaws for the teeth to be accommodated.
- referral to ENT surgeon to remove any nasal obstructions if applicable
- referral to a paediatric sleep physician if applicable
- myofunctional therapy to restore proper tongue and lip functions.
I encourage you to bring your child in for an assessment. In addition to the possibility of clearing an ADHD diagnosis, the health consequences of not treating sleep apnoea are very serious: more on that here.
“Our approach is not a one size fits all approach."