Sleep Apnea

Has your child been diagnosed with ADD/ADHD when they have obstructed sleep apnea?

• Are you being told there is nothing wrong with your child by your PCP or ENT physician?
• Is your child labeled having ADD/ADHD?
• Have you been going to physician to physician, and yet no one can find out why your child has so many symptoms that seem unrelated?
• Has anyone properly evaluated your infant’s tethered oral tissue, such as upper lip, upper check, or tongue for restrictions or airway blockage?
• Has the tongue been ignored as a different diagnosis for so many problems?

RTOTS (reflux due to tethered oral tissues) can contribute to more than 29 adverse systematic and localized health problems:

1. ­­Growth and development of the hard palate
2. Growth and development of the maxillary arch
3. Growth and development of the mandibular arch
4. Development of proper occlusion
5. Patency of the maxillary sinus: Nasal obstruction
6. Pseudo-macroglossia
7. Mouth breathing: Poor lip and tongue function
8. Diastema of either or both upper and lower central incisors
9. Speech problems
10. Posture abnormalities/pain
11. Facial growth and development
12. Dysfunctional breathing
13. SIDS
14. Interferes with proper latch for breastfeeding
15. Reduced milk production
16. Postpartum depression/failure to bond
17. Air induced reflux: Placed on adult anti-reflux meds
18. Enlarged tonsils and adenoids
19. Blocked airways
20. Sleep disordered breathing (30 or more symptoms)
21. Development of adverse behavior (ADD/ADHD)
22. Eating difficulties with solid foods (GI problems)
23. Failure to thrive in infants
24. Social/ sexual difficulties
25. Dental decay
26. Bed-wetting
27. Grinding teeth
28. Thumb sucking
29. Night fears

Sleep Disordered Breathing

Physicians are on the right tract if they evaluate the tonsils and adenoids, but they often ignore the effect of a tongue-tie.

Sleep-disordered breathing in children is a timely public health concern. As demonstrated in one study, a large percentage of children with hyperactivity or inattentive behaviors had underlying sleep-disordered breathing. These children would be cared for more effectively with appropriate recognition and treatment of sleep-disordered breathing than with the use of stimulant medications.

• Poor growth and failure to thrive are more common in children with sleep-disordered breathing.
• There is a strong correlation between sleep disordered breathing and reduced IQ.
• Sleep disordered breathing increase the possibility of ADD/ADHD by 50%.

Long-Term Sleep Apnea Concerns

Sleep apnea has several long-term consequences that can be problematic for later childhood development and may persist into adulthood.

If left untreated, OSA can cause poor growth (“failure to thrive”), high blood pressure, and heart problems. OSA can also affect behavior and cognition. Therefore, it is important to get it evaluated early in infants where the airway is compromised and the result may be reduced oxygen to the brain resulting in the behavior concerns and brain growth.

One of the most prominent long-term consequences of pediatric sleep apnea is the development of attention deficit hyperactivity disorder, or ADHD. In fact, up to 95% of obstructive sleep apnea patients have some level of attentional problems (Youseff et al., 2011). This has led to a high rate of misdiagnosis of ADHD, as some children labeled as having ADHD may actually be experiencing attentional issues related to a sleep disorder.

Jiang F: Sleep and Early Brain Development. Ann Nutr Metab 2019;75(suppl 1):44-54. doi: 10.1159/000508055