Sleep Apnea Seems to Cause ADHD, Why Isn't This More Well Known?

For quite some time, the literature on childhood sleep apnea has shown that sleep apnea leads to cognitive and behavioral issues.

Startlingly, repeated studies have found that a large portion of children who are diagnosed with ADHD have sleep apnea and that treating this sleep apnea helps to treat the symptoms of ADHD. I know of a study in the US and one in Taiwan that both showed the majority of a sample of ADHD-diagnosed children had sleep apnea. The Taiwan study performed adenotonsillectomy on some of these children and showed that it had positive behavioral improvements beyond those in a ritalin-treated control group.

Why aren’t children, and adults for that matter, before diagnosis with ADHD first given a proper polysomnography? I’m convinced that it is because sleep apnea is a disease that is not only poorly understood by lay people, but that even doctors who focus on sleep medicine don’t understand the true prevalence of sleep apnea in children and young adults, especially those who are not obese.

Why don’t doctors recognize the high prevalence even though it is documented in population studies? One reason, I think is because young people might not respond as well to PAP therapy as older sleep apnea patients, and many doctors see response to PAP therapy as the real signal that sleep apnea is present (ignoring PSGs, respiratory effort related arousals). The American Academy of Sleep Medicine has recently said that half of their accredited clinics are not using arousal based scoring of PSGs, which will leave a lot of children and young adults (and older adults for that matter) undiagnosed and improperly treated (as proper PAP titration requires a properly read PSG).

How many IQ points are lost to sleep apnea, and how much ADHD could be prevented through early recognition and treatment of sleep apnea? It seems like quite a lot and something that society should be investing in.

1 Like

I guess this explains in part why this isn’t more well known: https://twitter.com/alexeyguzey/status/1384693749746487298

This quote explains a good deal of doctors as well as psychiatrists.

yep…

Literally anything that causes neural inflammation will also “cause adhd” (can someone disprove this statement?)

It might be easier to replace all adhd research with something that directly measures neuroinflammation instead. I think most of the adhd research is unclear to the point of being effectively bs…

What exactly do you mean that “Intervention should be on the scale of neuroinflammation since that’s actually a measurable thing”?

Sleep apnea is actually a measurable thing, though there is work being done on better measurement as the main measurements used aren’t incredibly correlated with symptoms. Even with this poor correlation, we still get crazy things like the majority of people with ADHD having sleep disordered breathing as children.

I would think that for now treating neuroinflammation or whatever is the ultimate cause of ADHD may come down to eliminating sleep apnea, other causes of sleep fragmentation, or the other causes of neuro inflammation.

1 Like

Agree, my post was unclear, edited.