ADHD/sleep apnea

[SurvivorFan]

My soon to be 6year old son has ADHD. He recently had a sleep study done due to excessive teeth grinding. The study came back for him having several apnea events per hour. We have eval for ENT coming up to more than likely take out his adenoids. My question/s is apparently there is a correlate between apnea and adhd in kids in that adhd symptoms can be much more pronounced if apnea is at play. Do I think this could mean he doesnt have ADHD? NO. But I was wondering if any other parents have gone through similar situation and noted a positive change after surgery? Also, my little guy is highly anxious and any suggestions on how to approach the topic of surgery process to him would be great.

[Birdwatcher19]

Hi. I have not been through the surgery, but as sleep disruptions most definitely worsen ADHD symptoms, it stands to reason that improving sleep will help with his ADHD. (My brother has ADHD and sleep apnea, and treating his apnea has greatly helped him.) Regarding the anxiety, you can validate his feelings and give him some facts to correct any distorted ideas he has—e.g., it’s natural to be scared, but lots of kids have their tonsils removed and are fine (if you can provide any examples of someone he knows who’s had a minor surgery, even better), and you get to eat ice cream afterwards. You can see if there is a child life specialist at the hospital who can work with you. Also, the Kids Health website has great resources for talking to kids about surgery and all sorts of issues. Here is a link to some kid-friendly talking points on adenoids and adenoidectomies: kidshealth.org/en/kids/aden...

Good luck, hope all goes well!

[SurvivorFan in reply to Birdwatcher19]

Thank you for your advice and resources. I am so glad I found this place of support and knowledge early on in my kiddos life. It will be really interesting to see if the surgery helps with his mood. Over all he is doing good with his new med regimen (Ritalin SR) in am and 10mg short acting in the later afternoon but he can be moody/cranky. Thanks again!

[Birdwatcher19 in reply to SurvivorFan]

Of course. Is he moody/cranky all the time, or only when the medication is wearing off? I take short-acting Ritalin myself, and I definitely get a little irritable as it’s wearing off. Protein snacks and exercise help with that. Or just giving him some space and quiet time if that’s what he needs. If it’s all the time, treating his anxiety is likely to help with his mood. A therapist would be a great place to start if he doesn’t already see one.

[SurvivorFan in reply to Birdwatcher19]

Most of the time he is a pretty sweet little guy. We this past week just switched to a longer lasting ritalin in the morning and that has been a huge help for him being on a steady dose vs. The multiple doses/crashes during the day. We had trouble as first with really uncontrollable high energy/impulsive behavior after that wore off around 3:30 but since adding on the 10mg short acting it has helped a lot. He has always been a more sensitive/cautious kid. Does things on his own time. If he feels pushed into going down a slide or riding a bike for example he can have a teary/angry short outburst. Usually says something like bad mom/grandpa or whoever but then shortly after will apologize. As I mentioned always been very cautious kiddo but the past month or so has been having an odd sort of fear of going into the bathroom by myself or into the kitchen, ect. It will be the middle of the day and wants someone to take him to the pantry or bathroom. Says he is scared but says its something silly like spiders (but admits to never seeing a spider in our home) 🤷

[Birdwatcher19 in reply to SurvivorFan]

He sounds a lot like my older daughter. She is highly sensitive and very intense. Just keep an eye on the anxiety—it can present as anger/irritability in kids, and stimulants can sometimes exacerbate it. I’d definitely recommend working with a therapist if you find it’s not improving, and of course, always keep your prescriber in the loop.

[SurvivorFan in reply to Birdwatcher19]

Thank you. I agree definetly going to keep an eye on it and if any more odd fears pop up or current doesnt resolve will reach out to provider with concern.

[anirush]

My grandson was diagnosed with sleep apnea in middle school. They also recommended him having his tonsils out. It helped with sleep and he no longer woke up during the night but it did not fix his ADHD or anger problems completely, just made them easier to handle.

[SurvivorFan in reply to anirush]

Yes, curious to see if it helps him feel better mood wise😊

[Gxcccc]

Hi. Both my kids have ADHD and both had their tonsils and adenoids removed due to sleep apnea. The surgery makes a massive difference ... but it is not easy on the family as the kids are in quite a lot of pain for two weeks thereafter. But it is worth the suffering. Yes it will reduce ADHD-like symptoms because they will be less tired. But ADHD is basically low dopamine and surgery won’t change that.

[SurvivorFan in reply to Gxcccc]

Thanks Greg. Glad to be hearing from so many people that they notice a change for good in their kiddos behavior from getting better rest. Did both of your kids have obvious large tonsils/issues with them? My son according to sleep Dr and ENT has very small tonsils. Never has had issues with snoring, sore throats, etc. We had study done due to he teeth grinds pretty bad. Study came back conclusive for the grinding being due to an apnea event. ENT is saying is most likely his adenoids but very small chance that his tonsils could be playing a role. I am leaning towards just doing the adenoids since the recovery is so intense. He is finally taking his new non crushable stimulant like a pro and cannot afford to not have a good appetite for that long I feel.

[Gxcccc]

Good question. Our eldest had massive tonsils so his case was obvious. Our youngest did not. Our youngest had an overbite (his top jaw grew faster than his bottom jaw and this constricted his throat). So our ENT felt that his adenoids were further constricting his throat and resulting in sleep apnea. Our youngest had all the behavioural symptoms, restlessness whilst sleeping, etc but no snoring and no throat infections. He was taking a very long time to eat and, just prior to his operation, we had to be super careful that he didn’t choke on his food. The operation made a massive difference for both kids. Both had an adenotonsillectomy which is removal of tonsils and adenoids. We had to be guided by the expertise of our ENT and this expertise proved correct.

[SurvivorFan in reply to Gxcccc]

Its so interesting how differently it can present from kid to kid and how we do need to just trust the ENT is guiding us in the right direction. Again, I'm grateful to hear all the success stories after the surgery and hope its the same for us!

[Onthemove1971 in reply to SurvivorFan]

If you decide to go ahead with the surgery, please know we are wishing you all well and please update us, there is always someone wanting to learn from us.

[Hopeful7899]

Thank you for your post. My 6yo grinds his teeth to the extreme. I took him to dentist to try and get a guard of some sort. Dentist said he was too young for that. So we are still dealing with grinding. Now we have another route we can explorer.... Never would I have connected apnea and ADHD. Thank you!!

[SurvivorFan in reply to Hopeful7899]

Hi! Yes, our dr suggested the sleep study to rule out apnea. He also said it can be a sign of anxiety. Both made sense for our 6 y/o. The sleep study concluded he did have apnea so we removed his tonsils and adenoid. We saw a small improvement with adhd behavior( bit of a better mood) but nothing huge. We startled tackling the anxiety portion a few months ago and it has been a game changer. Night and day for our son. We have him on Ritalin short acting (slow release caused an increase in anxiety) Guanfacine am and pm, and fluoxetine. He is doing so awesome I cant believe what a change its made for him. If you have any questions I would be happy to answer. This platform has been a huge help for me ☺

[Onthemove1971]

I can't say much about having sleep apnea, but I can say we suffered so badly and I finally asked for medication to help him any time he has a medical procedure. In the past, when he was young we would have to have 2 staff members hold him down becuase he refused to have anything to do with needles. In the last year we are helping him ( both his doctors agreed) with a new sedation medication for the day of the procedure has really helped alot. I wish someone had told me about this option earlier. I just give him fully dose before any serious procedure.

Hope this helps.

[SurvivorFan in reply to Onthemove1971]

Im sorry you had to go through that when he was younger. I work with kiddos in medical enviroment and its always tough to have to do the hold. It makes perfect sense to have them take something before so it doesnt leave that awful memory each time.

[Onthemove1971 in reply to SurvivorFan]

I had so much stress every time we needed to do anything with a needle. So now we just give him the medication and there is no stress. As he matures and grows up he may be able to handle it but if not I am ok with that. There are many adults that need medication to fly on an airplane. I wish you the best.

[SurvivorFan in reply to Onthemove1971]

Exactly. There are plenty of adults who need a little valium or whatever to get through shots, MRI, plane rides...no shame in it☺

[Onthemove1971 in reply to SurvivorFan]

YES.. but the issue was we spent many.. many years with out son screaming and yelling ( and running with fear) and not being successful and no one told us or gave us this option when he was young. It is very painful to have to "force" a child to do a medical procedure that is necessary, but they refuse. I wish and that is why I am saying it now that more families knew that medication was an option for these types of procedures.

[SurvivorFan in reply to Onthemove1971]

Totally. I would be so frustrated also that not one of the providers offered another option to you. One of the biggest pieces of advice I have taken from this forum is to not settle for "that's just the way things are" when it comes to my son. As I know you know...stay on top of the doctors and push back when you know the kiddos need help! If I had not pushed for help with my son's anxiety and listened to just using a therapist he would still be sitting here terrified of starting kindergarten tomorrow! Now, with the therapy AND and SSRI he actually said he is excited for school!! My child who would sit outside counting the minutes until he could go back inside is now riding his bike and playing basketball for hours a day!

[Onthemove1971 in reply to SurvivorFan]

I am so excited for you! Way to go.. this journey is so hard but it is wonderful we are together as we travel.He will be so much successful in the future. I can see how being stable for a long time on medication helps children not self medicate with drugs. When children are stable and successful they don't need to do anything else.

Thanks for your support.

Take care!