Is sleep apnea making my child’s ADD/ADHD worse?

The short answer? Maybe!

Obstructive sleep apnea (OSA) is a fairly common, yet under-diagnosed condition in which the upper airway collapses during sleep. This leads to “microarousals” during sleep that prevents a good night’s rest.

The disorder is seen in both adults and children:

In adults, it usually manifests as daytime sleepiness.


In kids and adolescents, the symptoms are sometimes more subtle.  They can take the form of lack of focus in school, a perception of hyperactivity, or learning difficulties.  One recent study showed clear negative effects of OSA on behavior regulation and some aspects of attention and executive functioning. Furthermore, another study showed that urban schoolchildren with aggressive behaviors have symptoms of OSA at a significantly higher frequency than others.


If any of these symptoms sound familiar, you’re right! They overlap quite a bit with some of the symptoms of ADD/ADHD.

There’s no clear evidence that OSA causes ADD/ADHD. However, the manifestations of OSA can sometimes mimic that of ADD/ADHD. Additionally, in patients already diagnosed with ADD/ADHD, there is convincing evidence that OSA worsens symptoms of inattention and behavioral issues.


Most importantly, treatment of the OSA seems to have a favorable impact on behavioral issues.


So, what should you do?

Kids (or adults) with the diagnosis or suspicion of ADD/ADHD who also complain of excessive sleepiness during the day, snore loudly, or whose parents see them have pauses in breathing at night should be evaluated by a sleep specialist. It’s possible that further testing with a sleep study would then be warranted. Again, OSA does not cause ADD/ADHD — but it does seem that treatment can improve behaviors.

Post provided courtesy of Matthew J. Davis, MD


Find out more:

Sleep disorders in general,

NY Times Sunday Review article on this same subject.

Monmouth’s Sleep Lab,

Monmouth Neuroscience Institute’s Comprehensive Sleep Medicine Program.