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   Tonsillectomy may help some kids' ADHD symptoms

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Topic: Tonsillectomy may help some kids' ADHD symptoms (Read 585 times)

Rhune
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Tonsillectomy may help some kids' ADHD symptoms
« on: Apr 4^th, 2006, 10:44am »

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Tonsillectomy may help some kids' ADHD symptoms

By Amy Norton
4/4/06

NEW YORK (Reuters Health) - Children's behavioral problems, including symptoms of attention-deficit hyperactivity disorder (ADHD), sometimes improve after they have their tonsils removed, a new study has found.

The findings, published in the journal Pediatrics, support the theory that nighttime breathing problems -- and consequently poor sleep -- contribute to some children's behavioral difficulties during the day.

When the tonsils at the back of the throat become enlarged, they can obstruct the breathing passages. Chronic breathing problems are a chief reason tonsillectomy is performed in children.

The new study followed 78 children, ages 5 to 13, who were scheduled to undergo tonsillectomy, most often due to suspected nighttime breathing problems.

Overnight sleep tests performed before surgery confirmed that half had obstructive sleep apnea, a disorder in which breathing stops and starts repeatedly during the night - typically causing loud snoring and, often, daytime sleepiness.

The children also happened to have a high rate of behavioral problems, as measured from parents' reports and clinical assessments. A full 28 percent were diagnosed with ADHD, compared with only 2 percent of 27 children who served as a comparison group.

One year after the surgery, however, the children's behavioral and sleep problems were no greater than those of their peers. The rate of sleep apnea fell from 50 percent to 12 percent, and symptoms of sleepiness improved.

The particularly striking finding, according to the researchers, was that half of the children who had been diagnosed with ADHD before surgery no longer had the disorder one year later.

This doesn't mean that tonsillectomy is a "magic pill" for ADHD, Dr. Ronald Chervin, the study's lead author, told Reuters Health.

But parents and doctors may want to consider the possibility of a sleep disorder when a child is either hyperactive or excessively sleepy during the day, according to Chervin, who directs the sleep disorders center at the University of Michigan in Ann Arbor.

This is especially important when a child has a tell-tale breathing symptom such as loud, chronic snoring or a habit of breathing through the mouth. "I think a substantial minority of children with ADHD could benefit from having sleep problems addressed," Chervin said.

Surprisingly, though, sleep problems and behavioral problems did not necessarily match up among children in this study. Kids without full-blown sleep apnea were just as likely to have ADHD symptoms as those with the sleep disorder, and both groups showed similar improvements after having their tonsils removed.

This is unexpected, according to Chervin, because children with greater nighttime breathing problems should, in theory, have a higher risk of behavioral symptoms.

Chervin said he suspects the finding reflects a limited ability of current tests to detect milder nighttime breathing problems. He and his colleagues are launching a study that will investigate newer measures of sleep-disordered breathing in children.

SOURCE: Pediatrics, April 2006.

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yesteach
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #1 on: Apr 5^th, 2006, 5:14am »

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If the disorder was "gone" after the tonsillectomy, then the never had the disorder to begin with... they may have had symptoms of the disorder... but if you are truly ADD, it doesn't go away... There are enough people out there who already think there's no such thing as ADD, saying that a year after this surgery they no longer had ADD is only going to make more people convinced there is no such thing. Obviously they had some sort of sleep disorder, more likely than not sleep apnea, and removing the tonsils cured THAT, alleviating the sleep disorder... the symptoms of the sleep disorder had been MISDIAGNOSED as ADD... THAT would be a more responsible thing to say... *sigh*

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Rhune
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #2 on: Apr 5^th, 2006, 1:55pm »

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I have to agree, and I suspect you're barking up the right tree with the sleep apnea thing. I have to wonder, how many of these children were overweight as well, since that agravates sleep apnea.

« Last Edit: Apr 5^th, 2006, 1:55pm by Rhune »

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AoM
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #3 on: Apr 5^th, 2006, 3:08pm »

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*raises hand* count me in as one of those people who is with holding judgement on the ADD topic.

Sorry, i am old school. I think a small subset of the population may have some sort of neurotransmitter disorder that causes an inability to concentrate. This is NOT the same thing in my mind as being easily distracted. I think that most of the kids diagnosed with ADHD need a good case of discipline more than anything else.

My bf was diagnosed with that. Let me tell you, when he wants to focus on a TV show, or a video game or music or bowling, he's all there, not a problem, but if its something he doesn't want to do, uhoh, ADHD is kicking in again. Forgive me if i find that, BS.

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Rhune
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #4 on: Apr 5^th, 2006, 9:21pm »

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Well, if you've made up your mind, nothing is going to persuade you, but speaking as someone who has lived with it my whole life, and have only started taking medication for it now as an adult, I can tell you that it is VERY easy for someone with ADHD to "hyperfocus" on something interesting, or that stimulates the brain in certain ways (like video games), and still have ADHD and inattentive issues, especially when something is "boring". I have fought with that my whole life. It's not an excuse, it's something I struggle with.

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yesteach
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #5 on: Apr 5^th, 2006, 10:43pm »

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I agree Rhune, and it's much easier to focus on something like TV programs or video games because there is constant change.. you figure you only have to focus for 15mins, then you get a "commercial break" -

As for the video game... addictive tendencies is one of the comorbidities of ADD. For me, the thing with video games was, I HAD to win, if I didn't win, I was SURE I could win the next time because NOW I knew what to do... this is why I don't even THINK about gambling.. I'd be broke in a matter of hours.

Personally, my thing with ADD, since we don't use meds... is that there are ways to learn to compensate for the "weak" areas, while still being able to use the "strong" ones. I'm also VERY careful about what I eat. I've learned as I get older that certain foods make my ADD symptoms worse - I can't have too many carbs or I get severely depressed. When I do eat too many, I can eat high protein for a day and FEEL the depression lifting. I avoid red dye #40 because it makes me VERY hyper. I also avoid aspartame (NutraSweet) - I can tolerate it in gum and mints.. but any more than that and I get extremely irritable and if I get too much I get irrational. I also discovered years ago, when tuna was packed in cod oil. that it also causes me to be irrational and have a tendency to rage. I can't stand places that are overly crowded, I become highly agitated and if in that situation too long. I don't do malls! I'm extremely perfectionist... if I can't do something perfectly, I won't do it at all.

I realized long ago there is no way I'm ever going to balance a check book (hell, I don't even have a register in my checkbook... Undecided

), however, I have learned to use online banking VERY efficiently because it's fast.. and I'm not bogged down with the tedium of it. I pay for overdraft protection because I KNOW I'm going to end up overdrawn more often than not... all my bills are done with online billing because I forget to mail them (how many times has my phone been turned off because I wrote the check, put it in the envelope, stuck it on the visor of my car so I could drop it at the mailbox and left it there.... )

I also have absolutely no concept of time... my class is always late for lunch, always late for PE - until I learned to set the alarms on my PDA - one for PE time, one for Lunch time. I get "involved" in something (computer, reading, teaching) and that "hyperfocus" thing kicks in... ten minutes might as well be ten hours.. because one is just the same as the other.. I've gotten on the computer on a Saturday morning.. and before I realize it, it's getting dark outside.. it's not that I mean to spend 12hours online.. it doesn't "feel" like 12hours to my brain.

On the positive side, I'm extremely creative, I can multitask like you wouldn't believe, I am great at planning and organizing (I just can't do the follow through long term), and parents of ADD kids constantly request that they be put in my class, because I understand WHY they're the way they are.

I know there are people who think it's not real, and that it's just an excuse.. I only wish they could live one week in my head...

Also, the "attention deficit" is a misnomer... it's not that we can't pay attention, it's more the fact that we pay attention to everything! Hence the distractibility. There are no filters. I can't filter out noise... I have a fan running 24 hours a day in my house... I can't sleep if I turn it off... I drink coffee to fall asleep at night because it speeds up the neurotransmitters in my brain so all the the thoughts can process and I don't stay up all night with the "thoughts" running through my head.

Two of the best descriptions I've heard:

It's like trying to drive in the rain with bad windshield wipers.. you can see where you're going... but everything is run together and blurry...

It's like having a radio in your head on constant "scan." It never stops on a station, it just goes from one to another to another to another to another... and then back again.

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Rhune
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #6 on: Apr 6^th, 2006, 5:15pm »

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Oh lordy, I relate to so much of what you wrote there, Yesteach. I finally gave the checkbook over to my husband cause I couldn't stop bouncing checks. I also don't carry a register in my checkbook and use online banking. 12 hours is 12 minutes with video games...it just stimulates all the right senses in all the right ways and the rest of the world just slips into the background....whoosh...

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AoM
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #7 on: Apr 7^th, 2006, 4:56am »

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See, to me yesteach, you have described pretty much everyone I know. I feel that way too a lot of the time, i can't focus on something that doesn't interest me either.

But it just seems to me like sooo many people are getting diagnosed with this and then using it as an excuse to daydream or whatever (not saying that either of you do this, just from my own experiences)

I dunno, I kinda feel that if such a large proportion of the population is purported to have this problem, maybe its not a disease but a human condition. Not saying that eveyone shouldn't do their best to overcome such things, I just don't see how diagnosing every child with a wandering imagination as having ADHD is helping anything.

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Jeff
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #8 on: Apr 7^th, 2006, 10:14am »

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Well, I've never been diagnosed with ADD but that could be because I never got tested for it. A lot of my teachers throughout school always told both me and my parents that I really need to be tested for it.

Whether I actually have it or not, I don't know.

All I know is that I have found ways to cope with my inability to pay attention. No matter how hard I tried, I could never pay attention in class and my mind would wander off before I knew it. I love games, so I always played a lot of trivia games. Also, whenever there was an academic-related game going on, I'd always participate. Whenever teachers asked for volunteers to do something, I always volunteered. Making something interactive was the only way I could pay attention to anything. I tried to pay attention otherwise, but it got to the point where I'd concentrate on concentrating so hard that I wasn't even paying attention anymore.

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JP
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #9 on: Apr 7^th, 2006, 10:47am »

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Here's something I found where you can test yourself to see if you really needed to get tested for ADHD. The results here doesn't mean you have it, just that it will be worth your time to have yourself tested for ADHD. Luckily I don't think I have to be tested for ADHD.

http://www.add-adhd-help-center.com/newsletters/newsletter_31aug03.htm

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Jeff
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #10 on: Apr 7^th, 2006, 11:06am »

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on Apr 7^th, 2006, 10:47am, JP wrote:

Ok, 29 of them applied to me.

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yesteach
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #11 on: Apr 7^th, 2006, 10:01pm »

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on Apr 7^th, 2006, 10:14am, Jeff wrote:

I tried to pay attention otherwise, but it got to the point where I'd concentrate on concentrating so hard that I wasn't even paying attention anymore.

That statement, right there, as a teacher and as and ADDult, would tell me you are more than likely ADD.

JP, I couldn't get your link to work for some reason, but here is another one if anyone is interested. The doctor who owns this website has several books on ADD and the brain.. they are fascinating... his books are what gave me the heads up about watching for things in my diet that could aggravate my ADD...
http://amenclinics.com/ac/tests/

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Rhune
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Re: Tonsillectomy may help some kids' ADHD symptom
« Reply #12 on: Apr 9^th, 2006, 11:53am »

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I think that there are lots of people who at times exhibit ADD-like symptoms and do NOT have the condition at all (perhaps as suggested above, sleep deprivation is what plays a role in that). There are some children who get on ADHD medication and do not show improvement. Those children should be checked for sleeping disorders, and hopefully we'll start to see more of that! However, those of us that genuinely struggle with it, understand how real it is. Most people get better as adults, their symptoms lessen, but for some people like myself, it gets worse with age and reach a point where medication becomes a valid option. You do NOT need medication for ADHD/ADD, even if you have it, IF you are able to get the things done you need to. A student who is annoying because of ADHD, but is still able to complete their work does not need to be medicated no matter how convenient that would be for the teacher and the rest of the classroom. Overmedicating ADHD is a real problem in our society today, and I think there are many many children who absolutely don't need to be on it, and probably a good chunk of adults. For my part, I really do need the medication. I did reach a point where I wasn't coping well anymore and was not able to get basic and simple things completed each day. I found myself sleeping later and later in the day, and having no energy, and in the same token, having insomnia at night. In the semester before I started taking Adderall, my son was tardy to school 20 times because of me. My house was starting to look like a wreck, I was snappier at my children, and I just felt frantic all the time (because I was always forgetting everything). I was just overstimulated mentally once I had my 3rd child and simply lost my ability to cope. I wasn't suffering from depression, I just couldn't string two thoughts together and keep them together. I had to recognize I was miserable and that I needed to do something BEFORE I ruined my marriage over it. I have a great relationship with my husband, but I could tell it was starting to get as frustrating for him as it was for me. I tried Strattera first, hated it! I've since read that Strattera is better for kids than adults and that makes sense to me. I switched to Adderall after that, and felt an immediate result. Within a week I felt good and started getting things done again, started getting things caught up. Started sleeping deeper and for longer periods. When I started on ADHD medication I was struggling to get out of bed by noon. Now, after 6 months of taking it, it's normalized my sleep schedule. I feel tired by 1am and exhausted if I'm up past 2am, and I am waking up like clockwork at about 9am. I still forget some things, I still run a little late to most appointments (but at least I remember to go to them!). My son gets to school and picked up on time every day. My house gets picked up regularly, and I am getting all my work done. My short temper went away completely, I am calm and able to deal with my children fairly when they are being frustrating. The drugs didn't make me SuperWoman, but I am back to being Myself!

I guess the bit above about not believing in ADD and feeling like that describes everyone, is like migraine headaches. I have met people who don't believe they really exist. They've never had one, and everyone has bad headaches from time to time, and it's hard to pinpoint why people have them or if they are even really having one. It's one of those things you have to have felt personally to understand that they are not the same as a bad headache, and that they really do exist and are debilitating to some people. It's easy to feel the person is just faking it, or exaggerating the symptoms, if you're looking from the outside in. It's easy to feel angry or manipulated if they seem to occur when you have something important planned that they have not expressed much interest in. However, that doesn't mean they don't exist, or that there are some people who really do need medication for them.

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