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Misdiagnosing Children: Sleep Disorders Often Mistaken For ADHD

Research finds children with sleep breathing disorders are frequently misdiagnosed with ADHD, leading to inappropriate medication.

New research from Tel Aviv University (TAU) found that children suffering from sleep breathing disorders are often misdiagnosed with attention deficit hyperactivity disorder (ADHD) and prescribed unsuitable medication. 


Although trouble paying attention, forgetfulness, and poor impulse control are frequently linked to ADHD, these can also be symptoms of sleep deprivation. Furthermore, it can occasionally be difficult to distinguish between ADHD and sleep problems in children, as many of them struggle with both.


Researchers from TAU’s Maurice and Gabriela Goldschleger School of Dental Medicine found that children with sleep breathing disorders received ADHD medication at a rate seven times higher than kids who don’t have such disorders. 


Sleep breathing disorders are common among children. They are characterized by snoring and/or partial or complete interruptions of breathing during sleep, which causes a disruption of oxygen flow in the blood during sleep. 


The lack of oxygen flow can harm the growth and development of the child’s brain and cause cognitive and behavioral disorders, including learning difficulties, hyperactivity, fatigue and lack of concentration. Because the symptoms are similar to those of ADHD, this often leads to a misdiagnosis and unnecessary treatment with drugs such as Ritalin, leaving the actual illness untreated. The medication can sometimes even worsen the condition.


The study was conducted among 227 children aged four to 12 who were treated at the children’s clinic of the TAU School of Dentistry in the years 2020-2022.


The results of the original study were published in the Journal of Clinical Medicine on September 22, 2022. A follow-up study was published in the same journal in 2023.


The research was led by TAU’s Dr. Shani Kaminsky-Kurtz, Dr. Sigalit Blumer, Prof. Ilana Eli, Dr. Alona Emodi-Perlman, and Dr. Yarden Shreiber-Fridman. 


To raise awareness of the problem, the researchers compiled a list of four sleep-disordered breathing symptoms: taking medications for ADHD, discontinuous sleep, snoring, and mouth-breathing. 


They say that the symptoms are identifiable with the help of a simple questionnaire such as the US Pediatric Sleep Questionnaire, which can be completed by parents or family doctors. 


“The most reliable way of sleep-disordered breathing diagnosis is by monitoring children in a sleep lab,” said Kurtz-Kaminsky.


“But this is an expensive procedure with limited availability, and is also unsuited for children,” she added.

Produced in association with ISRAEL21c

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