ADHD or SLEEP APNEA: Get an evaluation @ FBH

ADHD or SLEEP APNEA: Get an evaluation @ FBH

  • Posted by DRP
  • On January 30, 2018
  • 0 Comments

Medications are not always the answer.

 

Having a good comprehensive evalauation is the answer.

A comprehensive evaluation can help you & your loved one(s) avoid intenssive treatments. 

You might just be a candidate for a sleep study referral instead of having to start medications for your focus problems or low energy.

The right treatment should match the right person. Personalized medicine versus cookie cutter service is a much better way to patient care. 

Our perspective at FBH is, "let the clinical situation justify the need for any intervention."

Fill out the easy appointment tab and we can discuss your concerns soon.

 

Sincerely,

M.Parvin,MD and the Entire Treatment Team at FBH

 

 

CHECK OUT THIS NATIONAL LIBRARY OF MEDICINE ARTICLE

It is a HUMAN CLINCAL TRIAL Done in the past 5 years. Very releveant and current.

Prognosis for Spontaneous Resolution of OSA in Children.

Abstract

BACKGROUND: 

Adenotonsillectomy (AT) is commonly performed for childhood OSA syndrome (OSAS), but little is known about prognosis without treatment.

METHODS: 

The Childhood Adenotonsillectomy Trial (CHAT) randomized 50% of eligible children with OSAS to a control arm (watchful waiting), with 7-month follow-up symptom inventories, physical examinations, and polysomnography. Polysomnographic and symptomatic resolution were defined respectively by an apnea/hypopnea index (AHI) <2 and obstructive apnea index (OAI) <1 and by an OSAS symptom score (Pediatric Sleep Questionnaire [PSQ]) < 0.33 with ≥ 25% improvement from baseline.

RESULTS: 

After 194 children aged 5 to 9 years underwent 7 months of watchful waiting, 82 (42%) no longer met polysomnographic criteria for OSAS. Baseline predictors of resolution included lower AHI, better oxygen saturation, smaller waist circumference or percentile, higher-positioned soft palate, smaller neck circumference, and non-black race (each P < .05). Among these, the independent predictors were lower AHI and waist circumference percentile < 90%. Among 167 children with baseline PSQ scores ≥ 0.33, only 25 (15%) experienced symptomatic resolution. Baseline predictors were low PSQ and PSQ snoring subscale scores; absence of habitual snoring, loud snoring, observed apneas, or a household smoker; higher quality of life; fewer attentiondeficit/hyperactivity disordersymptoms; and female sex. Only lower PSQ and snoring scores were independent predictors.

CONCLUSIONS: 

Many candidates for AT no longer have OSAS on polysomnography after 7 months of watchful waiting, whereas meaningful improvement in symptoms is not common. In practice, a baseline low AHI and normal waist circumference, or low PSQ and snoring score, may help identify an opportunity to avoid AT.

 

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PMC full text:
Published online 2015 Mar 26. doi:  10.1378/chest.14-2873

 

 

 

 

 

 

 

TABLE 2 ] 

Symptom, Questionnaire, and Historical Variables at Baseline as Predictors of Spontaneous OSA Resolution, as Assessed by PSG or Symptoms at 7-Month Follow-upa

 

 

 

 

 

 

  Polysomnographic Evidence for OSA Symptoms Suggestive of OSA
Baseline Variable Not Resolved (n = 112) Resolved (n = 82) P Value Not Resolved (n = 142) Resolved (n = 25) P Value
Habitual snoring     .64     .03
 Yes 88 (59.9) 59 (40.1)   120 (87.0) 18 (13.0)  
 No 16 (55.2) 13 (44.8)   9 (64.3) 5 (35.7)  
 Missing/not sure 8 (44.4) 10 (55.6)   13 (86.7) 2 (13.3)  
Loud snoring     .61     .04
 Yes 83 (60.1) 55 (39.9)   118 (88.1) 16 (11.9)  
 No 28 (56.0) 22 (44.0)   21 (72.4) 8 (27.6)  
 Missing/not sure 1 (16.7) 5 (83.3)   3 (75.0) 1 (25.0)  
Observed apneas     .58     .02
 Yes 52 (57.8) 38 (42.2)   76 (90.5) 8 (9.5)  
 No 55 (61.8) 34 (38.2)   51 (76.1) 16 (23.9)  
 Missing/not sure 5 (33.0) 10 (66.0)   15 (93.8) 1 (6.3)  
PSQ-SRBD scale total score, mean ± SD 0.48 ± 0.18 0.49 ± 0.17 .95 0.57 ± 0.14 0.44 ± 0.08 <.0001
 Snoring subscale 0.76 ± 0.28 0.74 ± 0.30 .63 0.85 ± 0.23 0.70 ± 0.31 .01
 Sleepiness subscale 0.43 ± 0.33 0.46 ± 0.31 .53 0.55 ± 0.30 0.45 ± 0.26 .14
 Behavioral subscale 0.46 ± 0.35 0.48 ± 0.34 .62 0.57 ± 0.32 0.41 ± 0.33 .03
PedsQL, parent 76.96 ± 15.57 77.30 ± 14.89 .88 73.65 ± 15.18 80.73 ± 11.50 .03
PedsQL, child 65.40 ± 14.52 67.07 ± 15.08 .44 65.02 ± 15.80 67.66 ± 13.79 .43
Conners ADHD 52.59 ± 11.67 52.72 ± 9.72 .93 55.40 ± 11.54 50.16 ± 6.59 .03
Hyperactivityb 53.69 ± 10.84 54.26 ± 9.92 .71 55.85 ± 11.15 51.84 ± 6.68 .09
Allergies     .07     .14
 Yes 52 (65.8) 27 (34.2)   62 (89.9) 7 (10.1)  
 No 60 (52.6) 54 (47.4)   79 (81.4) 18 (18.6)  
 Missing 1 (100)   1 (100)  
Nasal allergies     .78     .14
 Yes 27 (60.0) 18 (40.0)   36 (92.3) 3 (7.7)  
 No 83 (57.6) 61 (42.4)   102 (82.3) 22 (17.7)  
 Missing 2 (50.0) 2 (50.0)   4 (100)  
Use of nasal steroids     .92     .36
 Yes 10 (58.8) 7 (41.2)   14 (93.3) 1 (6.7)  
 No 102 (57.6) 75 (42.4)   128 (84.2) 24 (15.8)  
Use of montelukast     .65     .98
 Yes 4 (66.7) 2 (33.3)   5 (100)  
 No 108 (57.4) 80 (42.6)   137 (84.6) 25 (15.4)  
Frequent colds/influenza     .93     .50
 Yes 54 (58.1) 39 (41.9)   73 (86.9) 11 (13.1)  
 No 58 (57.4) 43 (42.6)   69 (83.1) 14 (16.9)  
Frequent ear infections     .06     .78
 Yes 9 (39.1) 14 (60.9)   20 (87.0) 3 (13.0)  
 No 102 (60.0) 68 (40.0)   122 (84.7) 22 (15.3)  
 Not sure 1 (100)    
Asthma     .12     .24
 Yes 41 (66.1) 21 (33.9)   50 (89.3) 6 (10.7)  
 No 70 (54.3) 59 (45.7)   88 (82.2) 19 (17.8)  
 Missing/not sure 1 (33.0) 2 (66.0)   4 (100)  
ADD/ADHD     .40     .99
 Yes 1 (33.3) 2 (66.7)   2 (100)  
 No 111 (58.7) 78 (41.3)   137 (84.6) 25 (15.4)  
 Missing 2 (100)   3 (100)  
Current smoker in household 0.54 ± 0.86 0.43 ± 0.80 .37 0.58 ± 0.89 0.20 ± 0.50 .05
Months of entry to study     .06     .93
 December-July 75 (53.6) 65 (46.4)   109 (85.2) 19 (14.8)  
 August-November 37 (68.5) 17 (31.5)   33 (84.6) 6 (15.4)  

Data given as No. (row %) unless otherwise indicated. ADD = attention-deficit disorder; ADHD = attention-deficit/hyperactivity disorder; Conner ADHD = Conners Rating Scale-Revised: Long Version, Attention-Deficit/Hyperactivity Disorder subscale; PedsQL = Pediatric Quality of Life Inventory; PSQ-SRBD = Pediatric Sleep Questionnaire Sleep-Related Breathing Disorder. See Table 1 legend for expansion of other abbreviation.

 

 

 

 

 

 

aTests were conducted excluding subjects with missing values.
bHyperactivity refers to Conners Rating Scale-Revised: Long Version, Hyperactivity subscale.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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