Ask the Doctor: How Prevalent Is Narcolepsy in Children with ADHD? What Causes Complex Sleep Apnea?

Kiran MaskiDo children with ADHD have a higher risk for narcolepsy? Could complex sleep apnea be related to problems with the vagus nerve? A medical expert answers! We are delighted to have Dr. Kiran Maski of Harvard Medical School, a renowned expert in pediatric neurology and sleep medicine (and a member of the Hypersomnia Foundation’s Medical Advisory Board), answer these questions.

At the 2016 Hypersomnia Foundation conference, Dr. Lecendreux showed the prevalence of ADHD in children with narcolepsy. What is the reverse, i.e., what is the prevalence of narcolepsy in children with ADHD?

ANSWER: The prevalence of ADHD symptoms in Lecendreux et al’s 2015 article was about 20% in pediatric patients with narcolepsy type 1 (narcolepsy with cataplexy) and 36% in pediatric patients with narcolepsy type 2 (narcolepsy without cataplexy). However, it is unknown what proportion of children diagnosed with ADHD have narcolepsy type 1.

Hi, my son has been suffering for at least 10 years. His diagnoses: age 16, fractured sleep architecture; age 17, insomnia; age 18, idiopathic hypersomnia, sleeping 14-22 hours daily; age 19-20, delayed sleep phase; age 24, now noted but never before, sleep apnea. After 2 sleep studies, it’s been deemed complex sleep apnea. What do we know about complex sleep apnea?

Also, my son has just been diagnosed with idiopathic gastroparesis (delayed emptying due to vagus nerve). Is there any connection between the vagus nerve and complex sleep apnea? Thank you, concerned and weary mom.

ANSWER: Complex sleep apnea is a relatively rare sleep disorder in which central apneas either persist or emerge once obstructive sleep apnea is treated (usually with CPAP or BiPAP). The underlying cause of complex sleep apnea is not well understood but is thought to involve the peripheral chemoreceptors and brain stem responses (not the vagal nerve specifically). Since I have not examined or treated your son, I am not able to surmise whether, or how, the multiple disorders your son has might fit together.

Read more about complex sleep apnea HERE.

Disclaimer for Ask the Doctor: The medical information provided is intended for educational purposes only and is not a substitute for professional medical care or advice. Every person is different, and questions about your own personal health conditions should be discussed with your own healthcare professional.

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