WEBVTT 1 00:00:00.640 --> 00:00:03.640 Good morning everybody, and welcome. It is June ninth, twenty 2 00:00:03.640 --> 00:00:05.639 twenty sixth. Today we're going to talk about an article 3 00:00:05.679 --> 00:00:09.240 that came in a journal of children's Health real quick. 4 00:00:09.320 --> 00:00:14.519 It says some children's ADHD might be a sleep problem. 5 00:00:14.519 --> 00:00:16.719 And here's why we're going to take a look at 6 00:00:16.719 --> 00:00:18.679 this in case you have a child that's in that 7 00:00:18.760 --> 00:00:22.039 category or you know somebody that does. Stay tuned, Hi, 8 00:00:22.079 --> 00:00:24.800 and welcome to Health Talk with Doctor Lynn. Your daily dose. 9 00:00:25.359 --> 00:00:28.160 The information you hear on the show is informational. It's 10 00:00:28.199 --> 00:00:31.839 not meant to diagnose or treat any disease. Any kind 11 00:00:31.879 --> 00:00:36.600 of complete health conditions must be checked out in discussed 12 00:00:36.640 --> 00:00:39.960 with your primary care physician. Get ready for the good 13 00:00:40.000 --> 00:00:43.719 news of the day. God bless you, folks, and here 14 00:00:44.039 --> 00:00:47.359 is doctor Lynn. Our daily devotional today comes from the 15 00:00:47.359 --> 00:00:50.600 Book of First Peter, Chapter four. Seek to live in 16 00:00:50.640 --> 00:00:54.119 My Love, which covers a multitude of sins, both yours 17 00:00:54.119 --> 00:00:57.039 and others. Where my love like a cloak of light 18 00:00:57.359 --> 00:01:00.560 covering you from head to toe. Have no fear, for 19 00:01:00.640 --> 00:01:04.200 perfect love decimates fear. Look at other people through the 20 00:01:04.280 --> 00:01:07.439 lenses of love, see them from my perspective. This is 21 00:01:07.480 --> 00:01:09.680 how you walk in the light, and it pleases me. 22 00:01:10.599 --> 00:01:12.879 I want my body of believers to be radiant with 23 00:01:12.920 --> 00:01:16.040 the light of my presence. How I grieve when pockets 24 00:01:16.040 --> 00:01:20.239 of darkness increasingly dim the light. Love return to me, 25 00:01:20.680 --> 00:01:24.200 your first love, Gaze at me in the splendor of holiness, 26 00:01:24.319 --> 00:01:29.439 and my love will once again envelop you in light. Oh, 27 00:01:29.560 --> 00:02:47.719 great thoughts, stay tuned seven two, seven, nine, one, six 28 00:02:47.840 --> 00:02:51.080 four two went five to reach me off air. You 29 00:02:51.080 --> 00:02:54.240 cannot explain expect a brain to perform at its best, 30 00:02:55.039 --> 00:02:57.639 but sleep is being interrupted hundreds of times at night, 31 00:02:57.719 --> 00:03:02.560 said doctor Muhammad Usama, a sleep medicine physician for children 32 00:03:02.599 --> 00:03:07.639 diagnosed with a tension deficit hyperactivity disorder. Sleep disordered breathing 33 00:03:08.520 --> 00:03:11.639 breathing is often an overlooked explanation, yet it's rarely checked. 34 00:03:12.439 --> 00:03:15.759 Sleep disordered breathing is abnormal breathing during sleep, raging from 35 00:03:15.840 --> 00:03:20.719 habitual snoring to sleep apnea, in which the airways reportedly 36 00:03:20.919 --> 00:03:24.680 narrow and collapse. This leads to either a disruption to 37 00:03:24.759 --> 00:03:27.919 sleep or a decreased in body oxygen levels, often both, 38 00:03:28.360 --> 00:03:32.120 said David Macintosh and ear nose and throat specialists James 39 00:03:32.120 --> 00:03:36.759 Cook University. The effects can extend to and affect multiple 40 00:03:36.840 --> 00:03:41.560 body symptoms, sometimes in obvious ways, sometimes more subtly, and 41 00:03:41.639 --> 00:03:45.319 children to two systems most commonly affected are the cardiovascular 42 00:03:45.360 --> 00:03:50.159 system and the brain. The connection between disrupted sleep and 43 00:03:50.240 --> 00:03:54.479 ADHD behavior is striking. Sleep disorders have been diagnosed and 44 00:03:54.560 --> 00:03:58.400 up to seventy percent of children with ADHD. Some estimates 45 00:03:58.439 --> 00:04:02.280 put the cooccurrence of sleep disordered breathing and ADHD as 46 00:04:02.360 --> 00:04:06.240 high as fifty percent. Poor sleep quality leads to difficulties 47 00:04:06.240 --> 00:04:10.919 with attention, impulse control, emotional regulation, and behavior during the day, 48 00:04:11.520 --> 00:04:16.560 symptoms that closely overlap with ADHD. This is from Athenaea Fae, 49 00:04:16.560 --> 00:04:22.800 a clinical psychologist specializing in neurodevelopmental disorders and ADHD. The 50 00:04:22.839 --> 00:04:27.160 mechanism is reasonably well understood. Reduced oxygen levels, repeated sleep interruptions, 51 00:04:27.240 --> 00:04:31.399 brain development, cognitive functions suffer Children with sleep disorder breathing 52 00:04:31.519 --> 00:04:35.839 also have elevated levels of inflammation, which may further contribute 53 00:04:35.879 --> 00:04:39.519 to poor attention span when sleep is disrupted. So are 54 00:04:39.519 --> 00:04:44.639 the vital physiological processes that regulate behavior. ADHD broadly includes 55 00:04:44.680 --> 00:04:50.040 two main components, hyperactivity and inattention. Sleep disordered breathing appears 56 00:04:50.079 --> 00:04:53.920 to drive both on the hyperactivity side. The children in particular, 57 00:04:54.399 --> 00:04:57.920 sleep disordered breathing impairs the prefrontal cortex, which is the 58 00:04:57.920 --> 00:05:02.240 brain's break on impulsive behavior. The inattention side is often 59 00:05:02.319 --> 00:05:05.720 driven by a simple brain fatigue. Sleep is a restorative 60 00:05:05.759 --> 00:05:10.040 process that supports focus and concentration. It's also when learning 61 00:05:10.120 --> 00:05:12.720 is consolidated into memory and the brain is reset for 62 00:05:12.759 --> 00:05:15.519 the day ahead. The effects can build over time. What 63 00:05:15.639 --> 00:05:18.839 bad night may have a subtle impact, but ongoing disrupted 64 00:05:18.879 --> 00:05:24.560 sleep can compound in significant cognitive consequences. Because sleep disordered 65 00:05:24.560 --> 00:05:28.839 breathing can closely mimic ADHD, misdiagnosis is a genuine and 66 00:05:28.920 --> 00:05:33.439 documented problem. When sleep disordered breathing is missed, the underlying 67 00:05:33.439 --> 00:05:37.079 disruption to multiple body symptoms continue. At the same time, 68 00:05:37.160 --> 00:05:42.480 medications that further impair sleep quality can be prescribed. Most 69 00:05:42.519 --> 00:05:46.720 of the medications are amphetamine based. Part of the issue 70 00:05:46.800 --> 00:05:49.680 lies in training and awareness. Many E and T conditions 71 00:05:49.720 --> 00:05:54.879 sleep disorders are not well covered in medical education DAH. 72 00:05:55.079 --> 00:05:59.000 The diagnostic question, the expert said, is not either or 73 00:05:59.319 --> 00:06:01.959 both conditions can be present. The goal is not to 74 00:06:02.000 --> 00:06:05.480 explain away ADHD, but make sure a treatable sleep disorder 75 00:06:05.519 --> 00:06:07.879 is not being missed. How would you know whether a 76 00:06:07.920 --> 00:06:11.959 sleep disorder might be present. Parents rarely come into clinics 77 00:06:11.959 --> 00:06:15.240 complaining that the child is habitually mouthed, breathing, snoring, or 78 00:06:15.319 --> 00:06:18.439 stops breathing during sleep. Instead, they tend to describe the 79 00:06:18.519 --> 00:06:21.639 downstream effects of poor sleep, said doctor Louise all of 80 00:06:21.720 --> 00:06:25.319 our family doctor and functional breathing practitioner, and her view. 81 00:06:25.399 --> 00:06:29.560 ADHD diagnostic assessments should not take place until sleep disordered 82 00:06:29.600 --> 00:06:34.120 breathing has been properly evaluated and managed. Sleep disordered breathing 83 00:06:34.120 --> 00:06:37.160 and children is usually identified through symptoms screenings and confirmed 84 00:06:37.160 --> 00:06:40.680 with an overnight sleep study that measures breathing, oxygen levels, 85 00:06:40.680 --> 00:06:45.000 and sleep patterns. Oliver recommends that parents observe their child's sleep, 86 00:06:45.040 --> 00:06:48.879 I encourage audio or visual recordings, I have abnormal breathing 87 00:06:48.959 --> 00:06:52.639 during sleep to assist in a child's assessment. More broadly, 88 00:06:52.680 --> 00:06:56.000 Oliver believes frontline care needs to shift to include structured 89 00:06:56.040 --> 00:07:00.600 sleep screening before an initial ad HD assessment, using simple 90 00:07:00.639 --> 00:07:04.519 questions about mouth breathing, snoring, or witness paused and breathing. 91 00:07:05.120 --> 00:07:09.000 It also requires clear referral pathways from primary care to 92 00:07:09.079 --> 00:07:13.920 e INT to pediatric sleep services. In clinical psychiatric practice, 93 00:07:14.120 --> 00:07:16.959 a sleep assessment is not usually done. According to doctor 94 00:07:17.040 --> 00:07:22.079 Samuel Pondhuthara, a child consultant an adolescent psychiatrist at London 95 00:07:22.160 --> 00:07:26.160 Psychiatry Clinic, a detailed history is often enough as it 96 00:07:26.199 --> 00:07:29.959 captures patterns and changes over time. Some clinicians who use 97 00:07:30.079 --> 00:07:33.759 data from smart watches or overnight sleep observation as measurement. 98 00:07:35.120 --> 00:07:37.839 When sleep disorder breathing is identified, treatment depends on the 99 00:07:37.839 --> 00:07:40.920 interline cause or severity. In children, the first step often 100 00:07:40.959 --> 00:07:44.639 focus on conservative and reversible factors such as managing nasal 101 00:07:44.639 --> 00:07:48.879 obstruction or allergic rhinitis losing weight, as they contribute to 102 00:07:48.920 --> 00:07:53.600 airway narrowing. In persistent cases, positive airway pressure therapy may 103 00:07:53.639 --> 00:07:56.279 be used, which involves a machine to deliver gentle air 104 00:07:56.319 --> 00:08:00.399 pressure to keep the airways open during sleep and children 105 00:08:00.439 --> 00:08:03.040 wear in large tonsils and adnoids may be a major 106 00:08:03.079 --> 00:08:10.079 contributing factor. Adnoid removal may be considered. Two main pressures 107 00:08:10.160 --> 00:08:12.759 drive sleep a build up of tiredness from daily activity 108 00:08:12.759 --> 00:08:15.879 in the body's internal clock, which is shaped by light exposure, 109 00:08:16.000 --> 00:08:21.079 melatonin and ADHD. This balance is often disrupted. The hormonal 110 00:08:21.160 --> 00:08:24.399 rhythm may be delayed or weaker. Switching off from a 111 00:08:24.439 --> 00:08:29.199 stimulated state can be genuinely difficult support. You have a 112 00:08:29.240 --> 00:08:30.879 good routine to wind down at the end of the 113 00:08:30.959 --> 00:08:33.000 day that use your energy at the right time so 114 00:08:33.039 --> 00:08:37.480 you're not activating yourself too close to bedtime. Managing light exposure, 115 00:08:37.559 --> 00:08:41.039 activity levels, temperature, and evening food choices can make a difference. 116 00:08:41.559 --> 00:08:44.519 In some cases. Long term melatonin may be prescribed to 117 00:08:44.600 --> 00:08:48.440 support sleep cycles, usually alongside not instead of those more 118 00:08:48.519 --> 00:08:53.879 foundational changes. Practical breathing focused strategies can also reinforce change. 119 00:08:54.360 --> 00:08:57.200 Many symptoms resolve when a child's sleep disorder breathing is 120 00:08:57.240 --> 00:09:00.919 addressed early. Look at the prep called sleep time and 121 00:09:01.279 --> 00:09:05.679 or calm day and or thaning. That's a three pronged 122 00:09:05.720 --> 00:09:09.159 approach that can be put together in a very nice 123 00:09:09.200 --> 00:09:12.480 way to help start the treatment pathway you want to 124 00:09:12.480 --> 00:09:15.120 help with that, give me a call. Seven two seven 125 00:09:15.480 --> 00:09:19.039 nine one six four two one five God bless your folks.