Hyperactivity associated with sleep apnea could be mistaken for ADHD

It is not commonly known, but sleep apnea can show as hyperactivity in some kids. Therefore, it could be mistaken for ADHD. In my search for an explanation for the hyperactivity of my toddler, even with the lack of sleep she has most days, I found out that in many cases, kids may not have ADHD. It could well be sleep apnea.

So here I am writing about my toddler’s sleep again, but this is a little more hopeful than the first one. I have always had a feeling that she was lacking sleep and when the pediatrician told me that everything was normal at her 12-month-old well check-up, I kind of put my feelings and thoughts aside. However, in the back of my mind, I knew that something did not make sense. Something about her sleep patterns and the fact that does not show tiredness after having a crappy night was not normal. It was not until she was almost 2 years old that I started to think more and more that something was not right. 

On one of those days just before she turned 2 years when she was overly hyper after we had had a crappy night, I started to do some research. I researched hyperactivity, ADHD, sleep patterns, and sleep apnea. Most of the articles about sleep apnea will tell you the most common signs of it: snoring, paused breathing, sleepiness throughout the day, etc. Very few will talk about a connection between hyperactivity and sleep apnea. I was blown away when I found articles talking about that connection and how sometimes it is misdiagnosed as ADHD. I only found that when I was reading about ADHD because some family members mentioned that my stepson was like that when he was little and made me wonder too. I have to admit that I was hesitant. I mean, hyperactivity could be ADHD but I still had no explanation for her sleep patterns. Then, as I researched more on sleep apnea, hyperactivity as a sign started to appear. It is not a common one but it certainly is one.

Hyperactivity is such an uncommon sleep apnea sign that not all pediatricians are knowledgeable about it. A little after she turned 2, I set up an appointment with her pediatrician hoping she knew about it. As I was telling her my worries about her sleep, my daughter was all over the room trying to wash her hands, open the trash can, climb up to the examination chair/bed, touching cables from the computer… Oh my God! It was around her nap time so she was all over the place because that is how she acts when she is tired. Even.more.hyper.

Anyway, I told the doctor that she would wake up for 2-3 hours in the middle of the night for 5 nights a week. It is more like 4 nights but from previous experience, I knew I had to exaggerate a little. I pointed out that her dark circles looked darker because of her constant lack of sleep. Do you know what she tried to tell me?

She started saying that maybe she was having a sleep regression (common when kids are around 2 years old). I immediately stopped her and said “No, I have been telling myself for two years that it could be that she was reaching certain milestones, or sleep regression, or teething, and it is not that because she does not get better. In fact, it seems that she is getting worse.” For her dark circles, she said it could be allergies. Ha! Ok, unless her allergies do not come with a runny nose or itchy nose/eyes, because she did not have any of those symptoms.

She asked about her sleep besides waking up for 2-3 hours in the middle of the night. “Does she snore?” she asked. I quickly thought to myself that if I said no, then she was going to dismiss this whole thing as being normal in some kids (like the other pediatrician told me on her 12-month-old well check-up).

So I lied.

I said that she snored a little but maybe it was the white noise that did not let me hear if it was loud enough. “Does she fall asleep on car rides?” I said that if it is her bedtime yes, but around her nap time, no. I told her that when my daughter was tired she would act like she was acting at the office, extremely hyper. I also mentioned that when she was asleep, at times, it seemed that her chest would sink a little too much. I was going to say more stuff like she moved a lot while sleeping (weird positions), and that she would have some labored breathing even when she would be just sitting down. But I did not. I was getting too distracted by my daughter thinking “what the heck, she cannot stop. Help!!!”

By this time, I had to hold my daughter in my arms because I could not take it anymore. I was getting super stressed out. She did not like it but I held her anyway!

Finally, the doctor said she was going to give me a referral for a sleep study! But you know what? I just had to ask her, “if it was not for the snoring, would you have referred my daughter for the sleep study?” She said no. I thought to myself “then I am glad I lied about it.”

As I was rocking my daughter in my arms from side to side (surprisingly, she got calm,) I then asked the doctor if she thought my daughter could have ADHD. She said it was too soon to know because she was barely 2 years old, and toddlers tend to be extremely active (I doubt it. As much as my daughter? nope).

However, she contradicted herself by saying that my toddler could be stuck in a cycle of not getting enough sleep and therefore shown as hyperactivity. Wow! Okay, now we were talking! So the sleep study referral was not just for the snoring huh?! I always thought that my daughter was running on adrenaline on the days she would get crappy sleep. She then checked my daughter’s tonsils. She said that they were somewhat large and that they could be a cause for her sleep disturbances. We left the doctor’s office and I felt somewhat relieved. I was glad I got that sleep study for my toddler because after that I could see if she has sleep apnea.

I just had to do what I had to do for my daughter and I do not regret it. That is what we have to do for our kids. We have to advocate for them because nobody, NOBODY knows them best. Not even pediatricians who have a lot of experience with kids are going to know our kids better than us. If we have to exaggerate a little or say a white lie, so be it!