| Obstructive Sleep Apnea |
- Snoring + witnessed apneas during sleep
- Daytime irritability and aggression (not hyperactivity)
- Poor school performance
- Obesity (BMI >95th %ile) = major risk factor
- Tonsillar/adenoid hypertrophy
- Improves with adenotonsillectomy
- Diagnosed by polysomnography (gold standard)
- Frequent nighttime arousals
- Morning headaches
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| ADHD |
- Inattention + hyperactivity + impulsivity in ≥2 settings
- Symptoms present before age 12
- No snoring or primary sleep disruption required
- Diagnosed clinically by DSM-5 criteria
- Treated with methylphenidate or amphetamines
- Behavioral therapy as adjunct
- More hyperactive (not just inattentive/irritable)
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| Depression |
- Persistent low mood + anhedonia ≥2 weeks
- Changes in sleep, appetite, and concentration
- Psychomotor slowing (not hyperactivity)
- Risk: family history, major life stress
- Treated with CBT + SSRI
- Social withdrawal more than aggression
- Suicidal ideation assessment required
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| Anxiety |
- Excessive worry + somatic complaints (stomachaches, headaches)
- School avoidance
- Separation anxiety in younger children
- Physical symptoms without organic cause
- Responds to CBT
- No snoring or primary sleep disturbance
- GAD vs separation vs social vs panic subtypes
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