It Is Just Attention-Deficit Hyperactivity Disorder…or Is It?
Dana C Won, Christian Guilleminault, Peter J Koltai and 3 others
PMID 28079611WHAT IT FOUND
A child's ADHD-like symptoms improved after adenotonsillectomy but recurred.
Palate expansion later resolved mouth breathing, with allergy treatment, behavior management, and a school plan. This case cannot show which treatment worked.
Key findings
01The child had an Apnea-Hypopnea Index of 8.2, and AHI greater than 1.0 is abnormal in children.
02After adenotonsillectomy, the child had immediate behavioral improvement, but symptoms recurred after one year.
03Follow-up polysomnography showed persistent obstructive sleep apnea, and palate expansion resolved mouth breathing.
STILL TO COME
How it was doneWhat they found
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What it does not show
Only a single child is described, so this cannot show that a treatment works for other children. Several treatments were given over time, including adenotonsillectomy, allergy treatment, palate expansion, behavior management, and a school plan, so the effect of any single component cannot be separated. Behavioral improvement after adenotonsillectomy was not permanent, because symptoms recurred after one year and follow-up testing showed persistent sleep apnea. The report does not give standardized outcome scores or a control group, so the size of any change cannot be judged. The article also contains specialist commentaries and general background, not only the child's own data.
The easy way to misread this
Do not conclude that adenotonsillectomy or palate expansion treats ADHD. Symptoms recurred after surgery, and allergy treatment, behavioral supports, and family or school factors were also involved.