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The article by Rappley et al1 is excellent and addresses a common problem we are facing currently.2 - 4 A lot of effort has gone into gathering data on this large patient population. Being interested in pediatric sleep medicine, I cannot emphasize the importance of screening these children with attention-deficit/hyperactivity disorder for sleep disorders such as obstructive sleep apnea, chronic sleep deprivation, or sleep-disordered breathing. One major difference between sleep-deprived adults and children is that children show hyperactivity, incoordination, learning difficulty, and behavior changes that can easily be mistaken for attention-deficit/hyperactivity disorder. I would request all my colleagues to ask a few basic questions about their patients' sleeping characteristics before prescribing any psychotropic medications to these young ones.
How long do they sleep in 24 hours?
Do they wake up by themselves, and are they rested?
Do they have any noisy breathing or difficulty breathing during sleep?
Does their daytime behavior show any signs of sleep deprivation?
Is there any chronic medical condition that can affect sleep (reactive airway disease, gastroesophageal reflux, seizure disorder, eczema, etc)?
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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