CHILD­HOOD SNOR­ING & BE­HAV­IOUR

Great Health Guide - - CONTENTS - Dr David McIn­tosh

The links be­tween snor­ing, teeth grind­ing, sleep-talk­ing, bed wet­ting & even ADHD

An­gel is a 6-year-old girl who is any­thing but her name­sake. She is tired and of­ten cranky, tends to burst into tears from the sim­plest of things, has very poor at­ten­tion and her be­hav­iour is such that her par­ents have been ad­vised by the school to see a pae­di­a­tri­cian in case she has At­ten­tion Deficit Hy­per­ac­tive Dis­or­der (ADHD). The par­ents re­alise that some­thing is not right with their An­gel and start re­search­ing a bit and seek­ing ad­vice from a range of pro­fes­sion­als. The pae­di­a­tri­cian con­firms she is dis­rup­tive and meets the cri­te­ria for ADHD. The au­di­ol­o­gist con­firms she can hear OK. The op­ti­cian con­firms her vi­sion is fine. The natur­opath sug­gests it might be a sen­si­tiv­ity to wheat and dairy and faced with the al­ter­na­tive op­tion of med­i­ca­tion, the fam­ily give this a go but un­for­tu­nately, she is only get­ting worse. They see the den­tist for her 6-month check-up and the den­tist notices that An­gel is strug­gling to breathe in the chair. Her mum says she has been like that for a while and tends to walk around with her mouth open ‘catch­ing flies’. The den­tist pro­ceeds to look at her teeth and notices some wear and tear sug­ges­tive of teeth grind­ing. Mum con­firms she does this too. The den­tist keeps prob­ing - it turns out the child snores and is quite rest­less at night. The den­tist takes a sec­ond look - this time past the teeth and looks at the back of the throat and notices the ton­sils are large. Mum con­firms this has been noted by oth­ers and was told that kids with big ton­sils just grow into them and be­cause there have been no in­fec­tions, they won’t be taken out by the spe­cial­ists. Hav­ing said that, no­body has or­gan­ised for An­gel to see the spe­cial­ists in ton­sil prob­lems, the ENT sur­geons. The den­tist of­fers a re­fer­ral to see one, which mum ac­cepts. At the con­sul­ta­tion the ENT spe­cial­ist con­sid­ers things in more de­tail. Not only does An­gel snore, but there are times when she may even stop breath­ing. She wakes

25-50%%of chil­dren with a di­ag­no­sis of ADHD actu-ally have sleep dis­or­dered breath­ing.

If a child snores there may be times when she even stops breath­ing.

up tired, wets the bed of­ten, grinds her teeth, sleep talks and has is­sues with her con­cen­tra­tion and fo­cus. The ex­am­i­na­tion con­firms the ears are fine, the nose is blocked at the back by large ade­noids. The ton­sils are so big that they are touch­ing each other. Fur­ther dis­cus­sion re­veals that she will have episodes of chok­ing on food and tends to avoid meat and prefers soft foods in gen­eral. The ENT spe­cial­ist ad­vises mum that An­gel has Sleep Dis­or­dered Breath­ing with prob­a­ble sleep ap­noea due to ob­struct­ing ade­noids and ton­sils. She ad­vises mum that re­search shows 2550% of chil­dren with a di­ag­no­sis of ADHD ac­tu­ally have a sleep problem and sleep dis­or­dered breath­ing is the most com­mon. Fur­ther­more, she ex­plains to mum that teeth grind­ing, sleep-talk­ing

and bed wet­ting will stop, in a high pro­por­tion of cases once the air­way ob­struc­tion is fixed. She ad­vises that the best way to cor­rect this is with surgery. It is for­tu­nate that An­gel does not get ton­sil­li­tis as the ton­sils are al­ready way too swollen and wait­ing for such in­fec­tions. Mum is re­lieved and hes­i­tant at the same time and asks about whether An­gel will just grow into them. The ENT spe­cial­ist ex­plains there was a study of 11000 chil­dren, in­clud­ing those that had sleep dis­or­dered breath­ing and had noth­ing done to fix it at the time, did of­ten stop hav­ing their breath­ing prob­lems. How­ever, their be­hav­iour prob­lems per­sisted. In an­other re­cent study of a cou­ple of thou­sand kids showed that in the group that had surgery early ver­sus the group that had no treat­ment, hav­ing surgery re­sulted in more sub­stan­tial im­prove­ments and bet­ter long-term out­comes. Re­al­is­ing her child was suf­fer­ing ter­ri­bly, mum de­cided to pro­ceed with surgery to re­move the ton­sils and ade­noids. An­gel had a rough re­cov­ery, as the spe­cial­ist ex­plained would hap­pen, but once it all set­tled down, mum was dumb­founded by the changes. An­gel was far more co­op­er­a­tive at school, had more en­ergy and every­one com­mented on how she seemed to be a new child. As the spe­cial­ist had ad­vised, the symp­toms of ADHD may just be re­flec­tive of her be­ing ex­hausted and tired and with the good nights of sleep that came with be­ing able to breathe well, she was able to func­tion bet­ter dur­ing the day. Even her eat­ing and swal­low­ing was bet­ter.

Teeth grind­ing, sleep-talk­ing & bed wet­ting will likely stop once the air­way ob­struc­tion is fixed.

She wouldn’t eat broccoli but hey, don’t ex­pect mir­a­cles.

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