April 20, 2012: The symptoms of sleep deprivation in children (feeling wired, moody, and obstinate; trouble focusing and sitting still) often resemble those of Attention Deficit Hyperactivity Disorder (ADHD). The latest study published in last month's Pediatrics provides the strongest link yet between sleep disorders and behavioral problems in children, finding that children whose sleep was affected by breathing problems like snoring, mouth breathing or apnea were 40% to 100% more likely than normal breathers to develop behavioral problems resembling ADHD. Kate Murphy reported on the study for the New York Times.
According to the Centers for Disease Control and Prevention, approximately 9.5% or 5.4 million children 4-17 years of age had been diagnosed with ADHD, as of 2007, representing a 22% increase in four years. Furthermore, the drugs used to treat ADHD (Ritalin, Adderall, Concerta) can cause insomnia.
Researchers, led by professor Karen Bonuck, department of Family and Social Medicine, Albert Einstein College of Medicine, New York, followed 11,000 British children for six years [as part of the Avon Longitudinal Study of Parents and Children, a long-term health research project of the University of Bristol], starting when they were 6 months old.
The study found that children at highest risk of developing ADHD-like behaviors had sleep-disordered breathing that persisted throughout the study but was most severe at age 2 1/2.
Bonuck's research builds on earlier, smaller studies showing that children with nighttime breathing problems did better with cognitive and attention-directed tasks and had fewer behavioral issues after their adenoids and tonsils were removed. The children were significantly less likely than untreated children with sleep-disordered breathing to be given an ADHD diagnosis in the ensuing months and years.
Most important, perhaps, those already found to have ADHD before surgery subsequently behaved so much better in many cases that they no longer fit the criteria.
The National Institutes of Health has begun a study, called the Childhood Adenotonsillectomy Study, to understand the effect of surgically removing adenoids and tonsils on the health and behavior of 400 children. Results are expected this year.
Written for California's Children by Elizabeth J Carlyle.