Please find quotations from a number of peer reviewed studies linking rhinitis, and sleep disordered breathing to ADHD.
“The vast majority of health care professionals are unaware of the negative impact of upper airway obstruction (mouth breathing) on normal facial growth and physiologic health. Children whose mouth breathing is untreated may develop long, narrow faces, narrow mouths, high palatal vaults, dental malocclusion, gummy smiles, and many other unattractive facial features, such as skeletal Class II or Class III facial profiles. These children do not sleep well at night due to obstructed airways; this lack of sleep can adversely affect their growth and academic performance. Many of these children are misdiagnosed with attention deficit disorder (ADD) and hyperactivity. It is important for the entire health care community (including general and pediatric dentists) to screen and diagnose for mouth breathing in adults and in children as young as 5 years of age. If mouth breathing is treated early, its negative effect on facial and dental development and the medical and social problems associated with it can be reduced or averted.”
In a paper entitled, “Pediatric allergic rhinitis: physical and mental complications”, Blaiss noted that allergic rhinitis has a far more negative impact on the health of the child than just a simple sneeze. “There are numerous complications that can lead to significant problems both physically and mentally in the child who suffers with allergic rhinitis. Under physical complications, recurrent and/or chronic sinusitis, asthma, and snoring impact children with AR. Sleep disturbances, poor school performance, and hyperactivity are all mental complications seen in many children related to their nasal allergies.”
In a study by Gottlieb et al., parent questionnaires from 3019 children were analysed to assess the prevalence of sleep-disordered breathing symptoms in five-year-old children and their relation to sleepiness and problem behaviours. Sleep-disordered breathing was defined as frequent or loud snoring, trouble breathing or loud, noisy breathing during sleep, or witnessed sleep apnea. The study found “parent-reported hyperactivity (19%) and inattention (18%) were common, with aggressiveness (12%) and daytime sleepiness (10%) reported somewhat less often. SDB symptoms were present in 744 (25%) children.”13 Authors concluded that “children with sleep disordered breathing symptoms were significantly more likely to have parent-reported daytime sleepiness and problem behaviors, including hyperactivity, inattention, and aggressiveness.”
Brawley et al. analysed data from 30 children to determine the prevalence of allergic rhinitis in patients with physician diagnosed ADHD. The paper concluded that “most children with ADHD displayed symptoms and skin prick test results consistent with allergic rhinitis. Nasal obstruction and other symptoms of allergic rhinitis could explain some of the cognitive patterns observed in ADHD, which might result from sleep disturbance known to occur with allergic rhinitis.”
Authors of the paper entitled, “Attention deficit hyperactivity disorder and sleep disorder,” note that “there is a clear correlation between ADHD and sleep disorders” and “by improving these children’s sleep, the symptoms of ADHD are diminished and thus avoid the need to administer psychostimulants, which have undesirable side effects that produce a great deal of anxiety in the parents of these children.”
In a paper published in the journal Pediatrics, researchers concluded that “inattention and hyperactivity among general pediatric patients are associated with increased daytime sleepiness and—especially in young boys—snoring and other symptoms of SDB. If sleepiness and SDB do influence daytime behavior, the current results suggest a major public health impact.”
“Children undergoing evaluation for ADHD should be systematically assessed for sleep disturbances because treatment of sleep disorders is often associated with improved symptomatology and decreased need for stimulants.”
In a paper entitled, “A practical approach to allergic rhinitis and sleep disturbance management,” Davies et al. comments that “sleep quality can be significantly impacted by nasal congestion. This may lead to decreased learning ability, productivity at work or school, and a reduced quality of life.”
