Is Excessive Daytime Sleepiness the Cause of Learning and Behavior Problems in Children?

For months now, I have been writing about the studies that are being published—seemingly by the month—linking obstructive sleep apnea (OSA) to more and more medical conditions, including hypertension,heart disease, mood and memory problems.

The latest research didn’t surprise me, but it did upset me more than usual — because it concerns our children, and the negative effects that poor sleep can have on their ability to pay attention, learn and control their behavior.

On May 1, the results of a study by Penn State researchers was published showing that children who have learning, attention and/or behavior problems may be suffering from a condition known as excessive daytime sleepiness (EDS)—even if tests indicate that they are getting enough sleep at night. 

For the study, the researchers conducted sleep testing on 508 children, and asked their parents to report if their child seemed excessively sleeping during the day. Then, the children were divided into two groups: children with excessive daytime sleepiness, and those without EDS. The results, published in the May 2012 issue of SLEEP,  showed that the children in the parent-reported EDS group were more likely to have "neurobehavioral” problems, including behavior/conduct problems, attention/hyperactivity and poorer performance in learning speed and working memory than children without indications of EDS.

What surprised the researchers was that, even if a child was in the EDS group, few also showed signs of short (not enough) sleep when tested. As a result, the researchers did not associate short sleep with any of the learning, attention and behavior problems.

So, what is causing these children’s extensive daytime sleepiness if they are getting enough sleep (at least on paper)? Like in adults, perhaps it is not just the length of sleep time, but the quality of sleep that determines restorative rest, or not.

A New York Times article from April 16, 2012 entitled “Attention Problems May Be SleepRelated”  also examined the relationship between children’s sleep quality and the ability to pay attention at school. The article was on another recent study called “Sleep-Disordered Breathing in a Population-Based Cohort: Behavioral Outcomes at 4 and 7 Years,” published in the Official Journal ofthe American Academy of Pediatrics. 

What I found disturbing about this article was that it pointed out that many cases of attention deficit hyperactivity disorder (A.D.H.D.) in children may have been misdiagnosed—that the cause of behavior such as moodiness and hyperactivity might in fact be due to obstructive sleep apnea (OSA) or other sleep disorder, which is causing sleep deprivation in the child. Worse, the drugs diagnosed for the A.D.H.D. are probably making the child’s symptoms worse!

This should be a call to arms for parents, caretakers, teachers and the medical community. If you know of a child suffering from sleep deprivation and/or extensive daytime sleepiness, and the symptoms that result, such as behavioral and learning problems … speak up and suggest they get tested for a sleep disorder first.

 Impairment due to EDS in daytime cognitive and behavioral functioning can have a significant impact on children's development. This is not to say that A.D.H.D. cannot be a true cause, but misdiagnosis of anyone—especially a child prescribed drugs—should not be tolerated.

Stay aware of the child’s behavior; look for clues, such as inattentive behavior and obesity, take a child’s “sleepy” complaints seriously … and then say something. You could be the reason a child’s neurobehavioral challenges are properly diagnosed and treated, leading to better behavior, greater ability to learn and a happier child.

Read the abstract of the report, “Learning, Attention/Hyperactivity, and Conduct Problems as Sequelae of Excessive Daytime Sleepiness in a General Population Study of Young Children.”

Summer’s Weather Causing Severe Allergy Season this Fall

Otolaryngology Associates, with two locations of its ear, nose and throat (ENT) practice in New York City, is seeing a surge in patients who suffer from ragweed allergies, and expect an unusually severe and extended season. The practice is also experiencing an uptick in patients that are affected by the non-seasonal airborne allergens such as mold and dust mites.

This summer, and extending into the early Fall, residents along the East Coast experienced a record-breaking summer of high-heat and record rainfalls. When combined, they formed the perfect storm to growth of these allergens.

In August, it was reported that the Northeast experienced record ragweed pollen counts. Ragweed thrives in lots of water and sun. It blooms around August and can continue producing pollen through the late fall until a killing frost. Weather experts expect that it will be a long blooming season because for the last decade killing frosts have been occurring later and later.

Hurricane Irene, which caused record-breaking rainfall all along the East Coast, caused severe flooding of “epic proportions” according to NASA. High levels of rain are also ideal for the proliferation of another common allergen, mold. Although it is not a seasonal allergen, mold multiplies quickly in damp conditions. The Northeast typically has much dryer weather conditions in late summer to early fall, and is expected to have unusually high levels of mold this year. Dust-mites are also a widespread allergen that has reached unusual levels due to the high heat experienced this summer.

Allergic reactions to air-born allergens can range from mild to severe. Usual symptoms include stuffy or runny nose, sneezing and itchy eyes. Other symptoms can include coughing, fatigue, and sore throat. These symptoms can sometimes lead to more serious conditions such as sinus and ear infections. Due to blockage in the nose, snoring is also a very common result.

Treatment of your allergies varies according to severity. Prescription nasal steroid sprays decrease the allergic reaction and inflammation in the nose. Non-sedating antihistamines treat the body’s natural reaction when it comes in contact with an allergen by blocking histamine which causes swelling and congestion. Allergy injections or immunotherapy, are for patients with long-standing allergies, and may be identified through skin or blood tests. They gradually reduce symptoms and the need for medication. If you’re not sure what it is that is causing your allergic reaction, an allergist can identify your allergy. It is important to treat your symptoms because they can lead to more serious conditions, and if they are interfering with your breathing or sleeping, seek treatment with an ear, nose and throat specialist.  

Chronic Sinusitis: The Cold That Won’t Go Away

Suffering from
Chronic Sinusitis

Are you suffering from a cold that’s been holding on? When it’s past Valentine’s Day and your sinuses have been stuffed up since before the Holidays or longer, you may have chronic sinusitis.

Sinusitis (sinus infection) is an inflammation of the sinuses and nasal passages. Its symptoms include a headache or pressure in the eyes, nose, cheek area, or one side of the head. You may also have a cough, a fever, bad breath, nasal congestion, nasal secretions, and you may snore at night.

Sinus infections are characterized by how long they last and the location of the affected areas. When one or more of the sinuses is infected for a short term, from a week to three months, it is considered acute sinusitis. When an infection lasts more than three months, it is considered chronic and is often caused by allergies or a physical abnormality such as a deviated septum, or malformed bone.

Chronic sinus infection symptoms may be less severe than an acute infection but it can also last for years. There are four types of sinus infections with varying symptoms and treatments which depend on the cause.

To treat chronic sinusitis due to allergies, prescription nasal steroid sprays can decrease nasal inflammation and can be safely used for a long period of time. Antihistamines that do not cause drowsiness can be used to reduce allergic nasal congestion, either alone or with nasal spray. Allergy injections gradually reduce symptoms and the need for medication and can help patients with allergies that have been identified through skin or blood tests.

Often antibiotics are combined with decongestants and/or nasal steroid spray as an effective way to eliminate chronic sinusitis. When that doesn’t work,  endoscopic sinus surgery is an option for those who do not respond to antibiotic therapy. Using a CAT scan of the sinuses to confirm the chronic condition, endoscopic sinus surgery may be used to drain the sinuses.

There is now a relatively new procedure called Balloon Sinuplasty™ that treats blocked sinus passages. It is a less-intrusive form of surgery that can be performed in a doctor’s office on an out-patient basis. During the procedure, an endoscopic catheter inserts a small, flexible balloon into the sinus passageways, and is then inflated. The balloon gently widens and restructures the walls of the passageways, enabling the sinuses to drain.

If you’ve been suffering from chronic sinusitis, contact your doctor today and schedule an examination, or if you’re in the New York City area, feel free to contact the Manhattan Snoring and Sleep Center for expert diagnosis.

Disclaimer:
This article is intended for general information only is in no way intended to be a substitute for receiving direct medical advice, diagnosis and treatment from a medical professional. Use and access to this website or any of the links contained within the site do not create a doctor-client relationship. If you have any questions regarding a medical condition, or if you suspect you may have a snoring disorder, contact your physician today.

Spring Allergies: Itchy Eyes, Sneezing… Snoring?

With the stretch of warm weather we’ve had this spring in the North East, nature is blooming in abundance. And I’m seeing an abundance of people seeking help for their snoring. Coincidence? Not likely. Every year at this time, it’s common for the simple reason that many people suffer from seasonal allergies. Allergic reactions can lead to symptoms that include suffering from snoring.

Allergies, as well as asthma, cold and sinus infections (sinusitis) can cause blocked airways. So, people who regularly sleep with their mouths closed with no symptoms of snoring, have to open their mouths to breathe while they sleep if they have reactions to allergies. The blocked airways make inhaling difficult and cause people to sleep with their mouths open, creating a vacuum in the throat that leads to snoring.

Allergic reactions can mimic sinusitis (sinus infection), which is an inflammation of the sinuses and nasal passages that is characterized by a headache or pressure in the eyes, nose, cheek area, or one side of the head. Patients with a sinusitis may also have a cough, a fever, bad breath, and nasal congestion with nasal secretions.

Nasal allergies, which are either seasonal or constantly recurring, increase nasal congestion and can lead to sinusitis. Numerous treatments are available to provide identification and avoidance of allergens. For example, this time of year dust allergies are common, whereas in the fall, mold allergies are more prevalent. Exposure can be reduced with the use of non allergenic bedding, removal of carpeting or upholstery, and the use of an air cleaner with a High Efficiency Particulate Air (HEPA) filter.

Additional treatment for nasal allergies include:

• Prescription Nasal Steroid Sprays which decrease allergic and non allergic inflammation in the nose and can be safely used for a long period of time.
  
  
• Non Sedating Antihistamines reduce allergic nasal congestion when used alone or with nasal spray.
  
  
• Allergy Injections are for patients with long-standing identifiable allergies (that may be identified through skin or blood tests). Allergy injections gradually reduce symptoms and the need for medication.

This time of year, with the many trees and flowers blooming, symptoms that lead to snoring are common, even in those who throughout the rest of the year don’t snore. If you’ve recently been snoring, and wish to know the reason why as well as get the appropriate treatment, contact the Manhattan Snoring and Sleep Center today.