A Cure for ADHD?

One out of four cases of ADHD eliminated. It almost sounds too good to be true. Nevertheless, a report in the preeminent journal Pediatrics suggests it's possible.

What needs to happen for this to occur? Some new miracle drug or radical kind of psychotherapy?Nope. All it could take is treatment of children's snoring.

ADHD is defined by a list of symptoms, so if a kid has those symptoms, then he likely has the disorder. But what causes those symptoms may vary from child to child. And sleep disorders could be one of those causes.

University of Michigan professor Ronald M. Chervin is one of the world's leaders in investigating sleep's role in ADHD. According to Dr. Chervin, unlike adults who suffer from sleep problems, sleep-disordered children are hyperactive. The version of this we're all familiar with is the crabby toddler who skipped his nap. When it gets more serious, as in the case of the kids Chervin sees in his lab, they are "bouncing off the walls. We treat these kids with a stimulant. Giving them a sedative just makes them worse. That showed that something else was going on."

Why could this be? As we wrote in NurtureShock, some of the brain's most important development─including the ability to regulate emotion─is done during slumber. Therefore, chronic sleep problems may be thwarting early brain development, because the children fail to progress through the necessary stages of deep sleep. In addition, disorders such as snoring might prevent sufficient oxygen from getting to a sleeping brain.

Some estimate that up to 16 percent of kids snore. Kids who do so are substantially more likely to have ADHD.

Chervin surveyed the parents of 866 kids about their children's sleep and behavior. The sleep-behavior relationship was so strong that he ultimately concluded that if children's sleep-disordered breathing could be improved (e.g., through tonsil or adenoid removal), one quarter of ADHD cases would be eliminated.

To test this theory, Chervin then studied 79 kids (5 to13 years old) who were about to have an adenotonsillectomy. Prior to the surgery, 22 of the 79 were categorized as having ADHD, based on standard measures for such a diagnosis. One year later, Chervin's team tracked down the kids for a follow-up. Of the 22 identified as having ADHD, 11 kids no longer qualified as having the disorder.

Chervin is a very careful scientist. He'd rather downplay his findings, rather than give anyone a sense of false hope. Still, he was willing to observe that "ADHD isn’t something that should just disappear a year later. That doesn’t happen."

There's another reason that Chervin remains extremely circumspect about his results. Not everyone benefited from the surgery, and there were some new cases of ADHD.

This suggests that the tonsillectomies were just too late: the damage had already been done. If so, that means there's a limited window of opportunity for the surgery to be effective.

Chervin's work isn't the only research to indicate that early sleep disturbances are related to long-term psychological problems.

Researchers have determined that a preschool boy with sleep problems is more than twice as likely to use alcohol and drugs and to smoke by the age of 14. He's more likely to be a bully in middle school and more depressed during high school. And he's also more likely suffer from anxiety in his 20s.

It used to be that the American Academy of Pediatrics thought that children's snoring wasn't a cause for immediate concern. However, in light of this new research, the AAP has changed its stance; it now believes there is no such thing as "benign" snoring.

The default answer can no longer be "She'll outgrow it." Because even if that were true, the damage may have already been done.