Does my child have a sleep disorder?

karenj · Joined: 22 Mar 2005 Posts: 110 Location: MS

My son has been diagnosed with ADHD,Odd, and an auditory processing disorder. I took him to an ENT and she said his tonsils looked ok but his nose looked horrible. He has and has had allergy and sinus problems(infections) since he was a baby. If he has normal tonsils could he have anything else that affects his sleep? He has snored since he was a baby and he sleeps with his mouth open.He is also very crabby and anxious in the morning when he has to get ready for school. He gets frustrated and kicks and throws things. I am just wondering if I should accept his ADHD diagnosis or look into it further.

karenj · Joined: 22 Mar 2005 Posts: 110 Location: MS

My son is 9 years old. He will be 10 in July. He has decided that he is "bored" when he takes his adhd medicine so I only give it to him on school days. He says he still needs it for school. With his medication he is on the A B honor roll and without it he can't concentrate to do his work. I've been reading alot about children with adhd being magnesium deficient. I'm going to talk to his pediatrician about it.

sleepinglizard · Joined: 27 Dec 2004 Posts: 1037

I recently heard an excellent talk at a conference where the Dr.'s research showed that children show sleep deprivation differently then adults. While adults may be grumpy, lethargic, etc., children were hyper, loud, etc. Further studies, showed that a healthy percentage of children diagnosed with ADD/ADHD, actually had sleep disorders when PSG's were performed. Furthermore, when these sleep disorders were properly treated, stimulant medication, were often not needed, and the ADD/ADHD symptoms went away. This is not to say that every child with ADD/ADHD has a sleep disorder. Nor is it to say that all children with ADD/ADHD does not exist as a separate disorder in and of its own right. It is simply one cause to rule out. I would highly recommend convincing your doctor to send your child for a sleep study. Your child may have to come off of stimulant medication for a significant number of weeks, so you will have to talk to the sleep specialist about whether it is necessary or not. So, you may want to have this happen in the summer.

Good luck!

If you are having trouble convincing the doctor, feel free to let me know an I will hunt down the doctor's name so that you can find his research.

karenj · Joined: 22 Mar 2005 Posts: 110 Location: MS

sleepinglizard, What is a PSG ? Is it a polysomnogram? I guess my real question here is if my son has regular sized tonsils is there any chance he has a sleep disorder?

karenj · Joined: 22 Mar 2005 Posts: 110 Location: MS

Since I have already taken my son to an ENt , who should I take him to next?

karenj · Joined: 22 Mar 2005 Posts: 110 Location: MS

Thank you Sadie M. You have been a big help. I will keep you posted. Very Happy

sleepinglizard · Joined: 27 Dec 2004 Posts: 1037

Karenj,

Yes, a PSG is a polysomnogram, the overnight sleep study.

Yes, with normal sized tonsils one can have a sleep disorder. People with normal sized tonsils can have other obstructions which effect their breathing. You mentioned that you're sons nose didn't look good due to allergies. That can have an effect on sleep. Additionally, there are other places in the oral tract where obstructions may exist.

However, there are more sleep disorders then just Sleep Apnea. There's restless leg syndrome, periodic limb movement disorder, as well as other sleep disorders.

I recommend sending your son for a sleep study with a board certified sleep specialist. I prefer neurologists or better yet a sleep specialist that specializes in children.

To find a board certified sleep specialist in your area, pleas go to the following web site. The doctors are organized by state.

http://www.absm.org/Diplomates/listing.htm

Personally, I recommend finding a board certified sleep specialist associated with a board certified sleep center. This ensures that the doctor, his staff, and his center have all received extra training and follow a certain standard.

To find a board certified sleep center in your area, please go to the site below. The centers are organized by state as well.

http://www.aasmnet.org/FindCenter.aspx

I apologize that it has taken so long for me to reply, but I had family business to attend to.

TASmonitor · Joined: 07 Oct 2003 Posts: 368

Opinions and advice expressed on the Talk About Sleep Message Boards are not to be taken as medical advice. If you have questions, your doctor should be consulted.

sleepinglizard · Joined: 27 Dec 2004 Posts: 1037

I beg to differ. All Neurological sleep specialists are trained to treat the Apnea first and only once the individual is 100% compliant on the correct machine at the correct pressure(s) should they retest and treat a neurological sleep disorder if necessary. A good Sleep Neurologist will not be med happy. Just like a good pulmonologist wont be PAP happy. If the sleep specialist neurological or pulmonary finds that Apnea's are a concern the individual will be sent to a sleep pulmonologist. However, if a neurological sleep disorder is president a sleep neurologist can identify and follow that as well. I am partial to sleep Neurologist and Sadie seems to be partial to Sleep Pulmonologist, however I think we both agree that a Sleep Specialists is definitely the doctor to see. Most clinics and good sleep practices will have both a Neurologist and Pulmonologist consulting and reading the study. You may want to find a practice of that nature. I still believe that a Sleep specialist that specializes in pediatric sleep would be the absolute best!

Guest · Posted: April 27 2005 Post subject:

Sadie,

I believe that I have been respectful. While I disagreed with a position that you made, I did not attack you nor did I invalidate your position.

sleepinglizard · Joined: 27 Dec 2004 Posts: 1037

Thought I was loged in. The guest above was me.

karenj · Joined: 22 Mar 2005 Posts: 110 Location: MS

I just wanted to thank you Sadie for all your input. I know you are posting to try to help people. I read your posts both here and on the sleep apnea board and they are always helpful. It is a good thing that newbies like me have people like you who are knowledgeable that will take the time to answer our questions. Keep up the good work!!!!!!!!!!!!!!!!!!!!!! Karen Very Happy

karenj · Joined: 22 Mar 2005 Posts: 110 Location: MS

Thanks, sleepinglizard. I looked up my sleep doc and he's on the list. When my son gets out of school for the summer I will take him to see him. Thanks for the info. Very Happy

sleepinglizard · Joined: 27 Dec 2004 Posts: 1037

Glad I could help out. Isn't it nice when you check and your doctor has the extra accreditations that exist?! It always makes me happy. Please, keep us posted on how things go.

Good Luck.

Spot · Joined: 02 May 2005 Posts: 49

I've done alot of research on this subject. Now my friend is doing her master's on it.

The American Academy of Pediatrics recently released new recommendations to all doctors that sleep discussions should be a routine care and assessment should be part of the differential diagnosis especially for children presenting with ADHD-like symptoms or behaviour difficulties.

This is a newly 'sexy' area of pediatric research, so support and diagnosis is getting better and better. From the research being released, as a general rule of thumb, children with 'severe' ADHD/ADD generally have true ADHD\ADD (though remember some children can have both). It's children from the 'mid-range' severity of ADHD\ADD symptoms where they find approximately 25% of these children have sleep disorders (most often obstructed breathing/apnea or RLS). After treatment, most of these children no longer met the requirements for ADHD\ADD. The most important part is early intervention, which is why the AAP made the recommendations.

Most cities have a pediatric clinic of some kind. Because apnea is the most common - itcould just be a pediatric apnea clinic. My friend's child who has restless legs was diagnosed by a pediatric neurologist.