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Writer's picturem.t. wilson, phd

Sleep Difficulties and Symptoms of ADHD in Children with Mouth Breathing

Literature shows that children with breathing problems like snoring, mouth breathing, or apnea are 40–100 times more likely to develop behavioral problems resembling ADHD (Schredl, Alm, & Sobanski, 2007).


Persistent mouth breathing affects stomatognathic functions along with effects on the academics and social life of a child. Therefore, Kalaskar et al. (2021) set out to examine sleep-related problems and behavioral symptoms similar to that found in attention-deficit hyperactivity disorder (ADHD) can be present in mouth breathers.


A cross-sectional study was carried out on 100 children of mouth breathing (consecutively selected) in 7–12 years of age using semi-structured proforma, children's sleep habit questionnaire (CSHQ), and diagnostic and statistical manual of mental disorders, version 5 (DSM 5). Statistical analysis was done using SPSS software version 21. Mean, standard deviation, Chi-square, and Pearson's correlation coefficient test were utilized during the analysis. p value of <0.05 was considered significant.





Results

Out of 100 children, 70 were males and 30 were females. On the CSHQ scale, the highest score was found on sleep-disordered breathing followed by sleep onset delay and daytime sleepiness. The commonest symptom of inattention was “failing to give close attention in school” (73%) whereas the commonest symptom of hyperactivity was “trouble waiting for his/her turn” (66%). Seven participants satisfied complete criteria for ADHD. Sleep duration and daytime sleepiness had a significant negative correlation with hyperactivity (p < 0.05). A positive correlation was observed between daytime sleepiness and inattention (p < 0.01).


Conclusion

Children with sleep disturbances or ADHD should be assessed for the presence of mouth breathing, as early identification and correction of mouth breathing may help to prevent unnecessary exposure to the medication.


Clinical significance

Children with ADHD or sleep disturbances should always be assessed for the presence of mouth breathing. Early identification and correction of mouth breathing may help in preventing unnecessary exposure to medication for treating ADHD.


Kalaskar R, Bhaje P, Kalaskar A, et al. Sleep Difficulties and Symptoms of Attention-deficit Hyperactivity Disorder in Mouth Breathing. Int J Clin Pediatr Dent 2021;14(5):604–609.

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