ADHD (attendion deficit hyperactivity disorder) is a condition affecting a growing number of children in our society. Symptoms include: hyperactivity, difficiluty concentrating for extended periors of time and memory deficits.
Treatment involves counselling, psychotherapy and possibly medication.
ADHD (also known as ADD – attendion deficit disorder) is thought to be caused by neurological or psychological factors.
But do we need to rethink this? Yes! We do.
See the medication generally prescribed is a stimulant, for instance ritalin. Why are we prescribing a stimulant for a child who has a condition that is supposedly hyperactive? Because the child is tired!
Unlike adults, who lounge on the sofa and have a catnap, when children are tired they become hyperactive to keep themselves awake. They don’t understand that resting will make them feel better.
Children with ADHD have breathing-disordered sleep.
If these children slept better, many of their symptoms would dissipate. Now I’m not saying that all ADHD sufferers have breathing-disordered sleep, but they should all be screened at least. In Iceland every child is screened for snoring. How good is that!
So what could be disrupting the sleep quality of these children? Well the enlarged adenoids and tonsils, ofcourse. There is a plethora of proper scientific evidence to show that removing the tonsils and adenoids (adenotonsillectomy) will improve ADHD in many children. Here is one such example, a meta-analysis – one of the strongest forms of evidence. It recommends that patients with ADHD symptoms should undergo sleep apnoea screening and treatment for this with adenotonsillectomy should be considered prior to medicating the child. I agree!
We simply cannot wait for the child to “grow out” of the enlarged tonsils and adenoids. Because by age four, 75% of craniofacial development is complete. And whilst tonsils are important for immunity, the complications arising from poor sleep quality due to enlarged tonsils far outweigh the argument to keep them.
You’ll find in most studies that an adenotonsillectomy will help many children with ADHD, but not all. Perhaps that is because many children have underdeveloped jaws which, in its own right, is a major risk factor for breathing-disordered sleep.
Early intervention orthodontics and orthopaedics is essential to guide the jaws towards appropriate development.
Dr Jalal is able to help your child with this.
