Children should not breathe through their mouths. Not while awake, not while asleep. NEVER. No one ever told me any of this.

“Parents, get ready for some ranting in all uppercase because this is going to change lives. Every single parent. If you have a child, I’ll tell you something you should know that you’ve probably never heard before. Also, please spread the word. In the photo I’m presenting with this story, there’s a giant red flag. Do you see what I mean?

CHILDREN SHOULD NOT BREATHE WITH THEIR MOUTHS CLOSED. Not when you’re awake, and not when you’re sleeping. Never.

Listen up if your child snores, grinds their teeth, wakes up in the night, has nighttime or daytime accidents, has impulse control issues, has under-eye circles, has crooked teeth or a misaligned bite, gets up abnormally early, is cranky during the day, or has a terrible appetite.

Let me take you back a year: Kian, my 8-year-old son, is determined, brilliant, feisty, and incredibly active. He began school with no issues in Kindergarten.

When first grade arrived, we began receiving conduct reports. ‘Kian pushed that person,’ ‘Kian is having trouble regulating his body,’ and so on. Parent-teacher conferences have been held, and a new reward system has been implemented, and things appear to be improving. At home, however, it was quite the opposite. When Kian is enraged, he is enraged. He becomes obsessed with minor details (there’s hair in the bathtub; it’s disgusting!). His fuse gets shorter and shorter, and he’s a finicky eater who rarely eats (I can’t shower in there! *meltdown begins*), and his fuse gets shorter and shorter (I can’t shower in there! *meltdown begins*).

When second grade arrives, oh boy. While some children grow out of their tantrums, Kian’s become more intense and evolve into daily spectacles, prompted by the tiniest of triggers. The school conduct reports begin to arrive. It goes on and on: ‘Kian is pushing,’ ‘Kian can’t control his urges,’ ‘Kian is having trouble staying in his seat,’ and so on. Almost every day. And I’m embarrassed. Every morning, before we even get out of bed, it’s tantrum after tantrum. Screaming, hitting, and hurling items are all part of the game. All of the screams Starting every morning at 5 a.m. We couldn’t figure out how he got this way, or what we could have done differently.

Kian begins therapy after his pediatrician recommends it. The therapist begins working with him and finally suggests that he be tested for ADHD. Meanwhile, Kian has a persistent cough that refuses to go away, so we’re visiting a pulmonologist as well as an allergist, against the pulmonologist’s advice. In a minute, this will be relevant. Each doctor is proposing an increasing number of prescriptions – two inhalers for the cough, an antibiotic for the postnasal drip (4 rounds), a steroid, and so on. The therapist keeps circling ADHD and nudging us in that direction. Kian’s dentist makes an offhand remark about his teeth during a cleaning — they were ground almost halfway down, and he grinds his teeth at night.

Then, at precisely the exact moment, lightning hit. I came upon an article that completely transformed our lives. The connection between ADHD, sleep disturbed breathing, and mouth breathing was discussed in the article. This article sounded exactly like Kian. This sent me down a rabbit hole of study (the majority of which was conducted in our own backyard at the National Institute of Health), where I discovered the following:

-Mouth breathing is NOT NORMAL and has long-term health implications. I’ll say it again because it’s crucial.

-BREATHING FROM THE MOUTH IS NOT NORMAL, DURING THE DAY OR AT NIGHT. A child’s brain (and body) do not obtain enough oxygen when they breathe through their lips. This decreased oxygen saturation during the night has a negative impact on the quality of their sleep and their brain’s ability to rest.

-The tongue cannot rest in the proper position when the mouth is open. This can lead to a narrow and high palate in the upper jaw, a recessed lower jaw (overjet and overbite can emerge), speech issues (r/l mispronunciation), and misaligned teeth over time. These changes restrict the airways, exacerbating the condition. The ensuing “long” face caused by these changes is referred to as “adenoid face” by medical practitioners.

-When sleeping, the recessed jaw can fully close off the airway and lead to sleep apnea in youngsters, in addition to the decreased oxygen. To compensate, the child’s body wakes him up and forces his jaw forward, causing sleep disturbances and tooth grinding (bruxism).

Then there’s this:

-Children with sleep deprivation and ADHD have similar symptoms. SYMPTOMS ARE EXACTLY THE SAME. Studies have been done (thank you, NIH) in which they took medicated ADHD kids, repaired the sleep-disordered breathing, and within 6 months, 70% of the kids had shown a resolution in symptoms and were no longer treated. As in, they were healed of their ADD/ADHD. It wasn’t ADHD, after all. 70% of children are affected. Allow that to sink in. This indicates that 70% of the children were given the wrong diagnosis of ADHD when they actually had a curable sleep condition.

-Stimulants – They always work until they don’t. Taking a stimulant will, of course, help you focus and feel “normal” if you are sleep-deprived. However, the brain never entirely rests, resulting in the following adverse effects: ‘nervousness, agitation, anxiety, sleep problems (insomnia), stomach discomfort, loss of appetite, weight loss, nausea, and suicidal ideation.’

Consider how you would feel if you were deprived of sleep for three days. Multiply the number by 100. Add a stimulant to the mix now. What do you think you’ll feel like once you’ve recovered from that? The list might go on forever.

Our story comes to a pleasant conclusion.

He was diagnosed with sleep apnea and sinusitis after a visit to an ENT and a sleep study. During the first study, he had exactly 0 minutes of REM sleep, oxygen saturation in the low 80s, and sinuses that were 90% blocked. We had no idea Kian had a headache every day, but it was nothing out of the ordinary for him, so he never told us. Kian’s tonsils and adenoids were removed, and the difference was immediately noticeable. He was able to breathe via his nose after surgery, whereas he couldn’t when he was wheeled in.

We’ve observed a complete change in attitude. It’s been a huge change: no more rage tantrums, no more obsession on minor OCD details. And we haven’t even gotten to the second step: correcting his jaw and tongue problems, which occurred as a result of his undetected sleep apnea. What’s the status of our follow-up sleep study? REM sleep for 360 minutes and oxygen saturation above the minimal level. In school, there are no behavior reports. His appetite has increased dramatically, he is no longer a finicky eater, and he saw a significant growth spurt two weeks after surgery. He still has minor sleep apnea, but the number of episodes per night has been decreased in half, as has the duration of each event. I can only imagine how much better it will be as we reach the finish line if we notice this much improvement now.

Here’s why I’m doing it: No one has informed me of any of this in my 12 years as a parent. All of the warning indicators were right in front of our eyes, and I had no idea what was going on. Kian’s pediatrician, whom we adored and trusted, remained silent throughout. When I requested that he be seen for this invisible health concern, the therapist had no idea, and the pulmonologist, allergist, and even the ENT and sleep doctor didn’t believe me. Not during any of our normal appointments, or during any of our appointments for sick children. No one believed us until we had hard evidence in the form of sleep study findings and sinus imaging. I had to track it down, diagnose it, and pursue treatment on my own. And I’m glad I did.

Please consult an ENT and obtain a sleep study if any of this raises red lights in your mind, if this sounds like your child, or if your child has been diagnosed with ADHD. It has the potential to change your life.

Please share this with others; you may be able to help someone — I wish I had had this information a long time ago!

–I’d want to add that I’m grateful for the vast reach and potential ripple impact this has. This is for you if you’ve messaged me or are considering emailing me with a question like, “This is my kid/This sounds like me/Can this be an issue for adults/Can you diagnose me?” I am unable to diagnose you; please consult a physician. See a doctor! That is the entire idea of this post. Consult an ENT (check with your insurance; I didn’t need a referral and scheduled an appointment on my own), and schedule a sleep consultation (also was able to book directly, check your insurance). Consult an expert. I can’t repair your medical problems for the love of all that is good; please consult a doctor!”