If a child snores there may be times when she even stops breathing.

concentration and focus. The examination confirms the ears are fine, the nose is blocked at the back by large adenoids. The tonsils are so big that they are touching each other. Further discussion reveals that she will have episodes of choking on food and tends to avoid meat and prefers soft foods in general.

The ENT specialist advises mum that Angel has Sleep Disordered Breathing with probable sleep apnoea due to obstructing adenoids and tonsils. She advises mum that research shows 25-

50% of children with a diagnosis of ADHD actually have a sleep problem and sleep disordered breathing is the most common. Furthermore, she explains to mum that teeth grinding, sleep-talking and bed wetting will stop, in a high proportion of cases once the airway obstruction is fixed.

She advises that the best way to correct this is with surgery. It is fortunate that Angel does not get tonsillitis as the tonsils are already way too swollen and waiting for such infections. Mum is relieved and hesitant at the same time and asks about whether Angel will just grow into them. The ENT specialist explains there was a study of 11000 children, including those that had sleep disordered breathing and had nothing done to fix it at the time, did often stop having their breathing problems. However, their behaviour problems persisted. In another recent study of a couple of thousand kids showed that in the group that had surgery early versus the group that had no treatment, having surgery resulted in more substantial improvements and better long-term outcomes.

Realising her child was suffering terribly, mum decided to proceed with surgery to remove the tonsils and adenoids. Angel had a rough recovery, as the specialist explained would happen, but once it all settled down, mum was dumbfounded by the changes. Angel was far more cooperative at school, had more energy and everyone commented on how she seemed to be a new child.

As the specialist had advised, the symptoms of ADHD may just be reflective of her being exhausted and tired and with the good nights of sleep that came with being able to breathe well, she was able to function better during the day. Even her eating and swallowing was better. She wouldn’t eat broccoli but hey, don’t expect miracles.