When your child is struggling with focus, hyperactivity, or impulsivity, the immediate thought for many parents and educators might be: “Is it ADHD?” Attention Deficit Hyperactivity Disorder (ADHD) is a well-known and widely diagnosed condition, but what if the symptoms you're seeing aren't rooted in neurodevelopmental challenges? Before jumping to medication, it’s critical to explore other possible causes—especially ones linked to airway health, like Sleep Disordered Breathing (SDB).
What Is Sleep Disordered Breathing (SDB)?
Sleep Disordered Breathing refers to a range of conditions that interfere with proper breathing during sleep. These can include:
Enlarged Tonsils or Adenoids: These can obstruct airflow, especially during sleep, leading to disrupted breathing patterns.
Tongue-Tie (Ankyloglossia): A restricted tongue can impair proper oral posture and contribute to airway issues.
Childhood Obstructive Sleep Apnea (OSA): Partial or complete airway blockage during sleep.
Upper Airway Resistance Syndrome (UARS): Increased effort to breathe due to airway narrowing.
Habitual Snoring: Often overlooked, persistent snoring is a RED FLAG and can be a sign of poor airway health.
Children with SDB often struggle with disrupted sleep cycles, leading to behavioral issues that mimic ADHD—difficulty concentrating, irritability, hyperactivity, and even learning challenges. Poor sleep quality can profoundly affect a child’s development and behavior.
How to Spot SDB in Children
Some warning signs of SDB in children include:
Chronic mouth breathing, either during the day or at night, which can indicate airway obstruction.
Restless sleep or unusual sleeping positions, such as sleeping with the head tilted back or in a sitting position to aid breathing.
Pauses in breathing, gasping, or choking sounds during sleep, which may suggest obstructive sleep apnea.
Persistent snoring, even if it’s not loud, as this can be a sign of narrowed airways.
Dark circles under the eyes, often referred to as "allergic shiners," which may signal poor oxygenation during sleep.
Morning headaches or difficulty waking up, due to disrupted sleep cycles and inadequate oxygen intake.
Behavioral issues like hyperactivity, inability to sit still, difficulty focusing, and irritability, often caused by fragmented sleep.
Frequent bedwetting, which can sometimes be linked to poor sleep quality or sleep apnea in children.
Myofunctional Therapy: A Natural Approach
Before starting myofunctional therapy, a thorough assessment is conducted to identify the root causes of the 'ADHD' behavior. Issues such as enlarged tonsils, enlarged adenoids, or a tongue-tie are carefully evaluated and addressed by referring to the appropriate professional. By working collaboratively with other referring professionals and a myofunctional therapist , an excellent result may be achieved. Myofunctional therapy, a lesser-known but effective intervention, focuses on improving the strength, tone, and coordination of the orofacial muscles. By addressing the underlying causes of Sleep Disordered Breathing (SDB), such as poor tongue posture and mouth breathing, myofunctional therapy can help open the airway, enhance oxygen flow during sleep, and reduce snoring or apneic episodes. These improvements directly contribute to better sleep quality and, as a result, can alleviate ADHD-like symptoms linked to fragmented sleep and low oxygen levels.
Children undergoing myofunctional therapy often show improvements in sleep quality, energy levels, and behavior, which may reduce the need for ADHD medications or additional interventions.
Benefits of Early Intervention
Addressing Sleep Disordered Breathing (SDB) with myofunctional therapy in children offers several key benefits that contribute to their overall health, development, and well-being. Here are the main advantages:
Improved Sleep Quality: Myofunctional therapy helps children breathe properly during sleep by correcting tongue posture and strengthening the orofacial muscles. This leads to fewer sleep disruptions, deeper sleep, and a more restful night’s sleep, which is essential for growth and development.
Reduced or Eliminated Snoring: Snoring, a common sign of airway obstruction during sleep, can be minimized or eliminated with myofunctional therapy. This allows for uninterrupted breathing and better oxygenation during sleep.
Prevention of Obstructive Sleep Apnea (OSA): By improving tongue posture and nasal breathing, myofunctional therapy helps prevent or reduce the severity of sleep apnea, a condition where the airway becomes blocked during sleep, leading to frequent waking and poor sleep quality.
Better Focus and Academic Performance: Children with undiagnosed sleep issues, like SDB, often struggle with concentration, focus, and memory. By improving sleep quality, myofunctional therapy can enhance cognitive function, leading to better academic performance and attentiveness in school.
Behavioral Improvements: Poor sleep from SDB can lead to irritability, hyperactivity, and impulsivity, which are often mistaken for ADHD. By addressing the underlying cause of these behaviors, myofunctional therapy can reduce these symptoms, improving emotional regulation and behavior at home and in school.
Reduction in Bedwetting: Some children with sleep apnea or other airway issues may experience bedwetting due to disrupted sleep. Myofunctional therapy can help improve sleep and reduce the frequency of nighttime accidents.
Enhanced Mood and Emotional Regulation: Consistent, high-quality sleep is essential for emotional health. Myofunctional therapy improves sleep patterns, which can result in better mood stability and emotional regulation for children.
Improved Physical Development: Myofunctional therapy can help children develop healthy oral and facial muscles, which contributes to proper jaw alignment, nasal breathing, and the prevention of malocclusions (misalignment of teeth). It promotes optimal facial skeletal development and supports long-term oral health.
Strengthened Respiratory Function: By promoting nasal breathing and addressing tongue posture, myofunctional therapy helps children breathe more efficiently, which can lead to better oxygenation throughout the body and improved overall health.
Non-Invasive Treatment: Myofunctional therapy is a natural, non-invasive treatment option for SDB. It offers a drug-free solution that can be used alongside other treatments or as a first step before considering medications or surgeries, making it an appealing option for many parents.
Improved Social Interaction: By improving mood, focus, and behavioral issues, children who undergo myofunctional therapy for SDB may experience better social interactions and stronger relationships with peers and family members.
Support for Long-Term Health: Addressing SDB early through myofunctional therapy can set the foundation for healthy breathing habits and proper facial development, which can prevent future dental, respiratory, and sleep-related issues as the child grows.
In summary, addressing SDB with myofunctional therapy in children not only improves sleep and breathing patterns but also has far-reaching benefits for emotional, cognitive, and physical development. It provides a holistic, non-invasive approach to addressing behavioral and health issues associated with poor sleep, potentially reducing the need for medications and fostering better overall well-being.
When to Seek Professional Help
Parents might be unaware of poor sleep or breathing issues that contribute to ADHD-like symptoms. Before starting medication, it’s important to consult professionals like a myofunctional therapist, a dentist experienced in airway awareness, or an ENT specialist to pinpoint underlying causes. Assessments could include:
Consultations with a myofunctional therapist.
Airway-focused dental evaluations.
Sleep studies to assess breathing patterns.
Evaluating enlarged or "kissing tonsils" where the tonsils are touching at the back of the throat.
Evaluating enlarged adenoids. It is quite common to have enlarged adenoids when the tonsils are enlarged in a child. Having both enlarged tonsils and adenoids take up airways space and prevent nasal breathing. For the importance of Nasal Breathing , please refer to my previous blog post:
Takeaways: Investigate Before You Medicate
While ADHD is a valid diagnosis for many children, it’s not the only explanation for behavioral and focus challenges. Sleep Disordered Breathing and airway health issues are often overlooked but could be the root cause of your child’s struggles. By addressing these underlying issues, you might find that behavioral symptoms improve dramatically—without the need for medication.
If you’re concerned about your child’s behavior or focus, take the time to investigate all possible causes. Treating airway health and improving sleep could be the first step to unlocking their full potential.
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