Abstract:Aim Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder characterized by severe inattention, hyperactivity, and impulsivity. This research aims to determine the frequency of ADHD symptoms in children who were treated in emergency paediatric services due to unintentional injuries. MethodThis study was carried out with children who were treated due to unintentional injuries in an Emergency Department. ADHD symptoms were evaluated using the DSM-IV-based Screening and Assessment Scale for B… Show more
“…20 In a similar study, İz et al showed that ADHD symptomatology was observed in most children admitted to the emergency department for accidental injuries. 22 Children with impulsive-hyperactivity behavior have been reported to have 1.5-2 times higher risk for injury and extremity fractures. [21][22][23][24][25] In a retrospective cohort study, Guy et al assessed musculoskeletal injuries in patients aged under 17 years with ADHD.…”
Section: Resultsmentioning
confidence: 99%
“…22 Children with impulsive-hyperactivity behavior have been reported to have 1.5-2 times higher risk for injury and extremity fractures. [21][22][23][24][25] In a retrospective cohort study, Guy et al assessed musculoskeletal injuries in patients aged under 17 years with ADHD. In the 11-year study period, the following traumatic musculoskeletal injuries were diagnosed in patients with ADHD; sprains (27.2%), fractures (21.2%), concussions (4.5%), dislocations (2.8%), and thoracic and pelvic injuries (0.6%).…”
Osgood-Schlatter's disease (OSD) is an overuse injury caused by tension on the patellar tendon placed on the anterior tibial tubercle. It presents with local pain, swelling and tenderness over the tibial tuberosity and most frequently occurs in girls between the age of 11 to 13 years and in boys between 13 and 15 years. The symptoms are usually exacerbated with sporting activities that especially involve jumping, running or stair climbing. 1-3 Radiologic studies have led to the theory that OSD may be caused by chronic tensile stress on the patellar tendon within the growth plate, which leads to irritation and inflammation. Inflammation results from micro-trauma to the growth plate with repetitive use before closure of the epiph
“…20 In a similar study, İz et al showed that ADHD symptomatology was observed in most children admitted to the emergency department for accidental injuries. 22 Children with impulsive-hyperactivity behavior have been reported to have 1.5-2 times higher risk for injury and extremity fractures. [21][22][23][24][25] In a retrospective cohort study, Guy et al assessed musculoskeletal injuries in patients aged under 17 years with ADHD.…”
Section: Resultsmentioning
confidence: 99%
“…22 Children with impulsive-hyperactivity behavior have been reported to have 1.5-2 times higher risk for injury and extremity fractures. [21][22][23][24][25] In a retrospective cohort study, Guy et al assessed musculoskeletal injuries in patients aged under 17 years with ADHD. In the 11-year study period, the following traumatic musculoskeletal injuries were diagnosed in patients with ADHD; sprains (27.2%), fractures (21.2%), concussions (4.5%), dislocations (2.8%), and thoracic and pelvic injuries (0.6%).…”
Osgood-Schlatter's disease (OSD) is an overuse injury caused by tension on the patellar tendon placed on the anterior tibial tubercle. It presents with local pain, swelling and tenderness over the tibial tuberosity and most frequently occurs in girls between the age of 11 to 13 years and in boys between 13 and 15 years. The symptoms are usually exacerbated with sporting activities that especially involve jumping, running or stair climbing. 1-3 Radiologic studies have led to the theory that OSD may be caused by chronic tensile stress on the patellar tendon within the growth plate, which leads to irritation and inflammation. Inflammation results from micro-trauma to the growth plate with repetitive use before closure of the epiph
“… 18 On the other hand, ADHD can cause sleep-related obstructive breathing, altered pattern of sleeping, and daytime sleepiness which has a negative impact on school performance and social life. 19 – 21 In community studies with different cultures, mouth breathing and ADHD are observed together in 54 and 5–13% of children in different studies. 1 , 17 , 22 In the current study, 7% of the mouth-breathing children full filled the complete DSM V criteria of ADHD which accurately diagnoses ADHD.…”
Aims and objectives
Persistent mouth breathing affects stomatognathic functions along with effects on the academics and social life of a child. Sleep-related problems and behavioral symptoms similar to that found in attention-deficit hyperactivity disorder (ADHD) can be present in mouth breathers. This study aims at assessing the sleep disturbances and pattern of symptoms of ADHD in children with mouth breathing.
Materials and methods
A cross-sectional study was carried out on 100 children of mouth breathing (consecutively selected) in 7–12 years of age using semi-structured proforma, children's sleep habit questionnaire (CSHQ), and diagnostic and statistical manual of mental disorders, version 5 (DSM 5). Statistical analysis was done using SPSS software version 21. Mean, standard deviation, Chi-square, and Pearson's correlation coefficient test were utilized during the analysis.
p
value of <0.05 was considered significant.
Results
Out of 100 children, 70 were males and 30 were females. On the CSHQ scale, the highest score was found on sleep-disordered breathing followed by sleep onset delay and daytime sleepiness. The commonest symptom of inattention was “failing to give close attention in school” (73%) whereas the commonest symptom of hyperactivity was “trouble waiting for his/her turn” (66%). Seven participants satisfied complete criteria for ADHD. Sleep duration and daytime sleepiness had a significant negative correlation with hyperactivity (
p
< 0.05). A positive correlation was observed between daytime sleepiness and inattention (
p
< 0.01).
Conclusion
Children with sleep disturbances or ADHD should be assessed for the presence of mouth breathing, as early identification and correction of mouth breathing may help to prevent unnecessary exposure to the medication.
Clinical significance
Children with ADHD or sleep disturbances should always be assessed for the presence of mouth breathing. Early identification and correction of mouth breathing may help in preventing unnecessary exposure to medication for treating ADHD.
How to cite this article
Kalaskar R, Bhaje P, Kalaskar A,
et al.
Sleep Difficulties and Symptoms of Attention-deficit Hyperactivity Disorder in Mouth Breathing. Int J Clin Pediatr Dent 2021;14(5):604–609.
“…The rate ratio for ADHD with one or more comorbid mental health conditions versus ADHD only is 4. 19 ). Other rate ratios measuring the association between poisoning, burns, and head injuries and OCD or depression or anxiety are even lower, albeit positively significant (data not shown).…”
Section: Rates Of Injury By Adhd Status and Comorbid Mentalmentioning
confidence: 99%
“…Research has shown that ADHD is positively associated with emergency services, hospitalization, and healthcare claims for injuries [17][18][19][20][21][22]. A study involving medical claim data in the U.S. showed that for ages 0-64 years, more severe injuries (versus less severe injuries) and an increasing number of injuries were positively association with ADHD [17].…”
Background. To describe the influence of attention-deficit hyperactivity disorder (ADHD) and comorbid mental health conditions on the risk of selected injuries. Methods. A retrospective cohort study design was employed using medical claim data from the Deseret Mutual Benefit Administrators (DMBA). Mental health conditions, injury, medication, and demographic data were extracted from claim files for ages 4-64, years 2016-2020. Results. Approximately 51.8% of individuals with ADHD had one or more comorbid mental health conditions (anxiety [37.0%], depression [29.9%], autism spectrum disorder (ASD) [3.6%], bipolar disorder [4.7%], obsessive compulsive disorder (OCD) [2.4%], schizophrenia [0.9%], and manic disorder [0.2%]). The rate of injury was 1.33 (95% CI 1.27–1.39) for ADHD only versus no ADHD and 1.62 (95% CI 1.56–1.68) for ADHD and comorbid mental health conditions versus no ADHD, after adjusting for age, sex, salary, and year. Cases with ADHD but no comorbid mental health conditions versus no ADHD were at increased risk of each of 12 types of injury. The increased risk was noticeably more pronounced for ADHD cases with one or more comorbid mental health conditions versus no ADHD. The greatest increased risk of injury was among ADHD cases with comorbid schizophrenia, followed by bipolar disorder and OCD. Comorbid autism disorder does not increase the risk of injury, but lowers it. Finally, the number of comorbid mental health conditions among ADHD cases was positively associated with increased injury rates (6% for one, 30% for two, 65% for three, and 129% for four). Conclusions. ADHD is positively associated with an increased risk of injury. Comorbid mental health conditions further increase the risk of injury among those with ADHD.
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