SUMMER 2017
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21
MURALIDHAR IDAMAKANTI, MD
RESIDENCY PROGRAM
Chief Resident, Medicine
HOMETOWN
Yallur, India
NEXT STEP
Hospitalist, SBH Health System,
Bronx, NY
LONG TERM PLAN
Continue in an academic program
JIMMY TRUONG, MD
RESIDENCY PROGRAM
Chief Resident, Emergency
Medicine/Family Practice
HOMETOWN
Brooklyn, NY
NEXT STEP
Emergency Medicine attending,
New York Presbyterian Medical
Center, NYC
LONG TERM PLAN
Teaching and working with residents
APARNA YADATORE, MD
RESIDENCY PROGRAM
Chief Resident, Pediatrics
HOMETOWN
Bangalore, India
NEXT STEP
Pediatrician, federally-qualified
health center
LONG TERM PLAN
Interested in working in private
practice in areas of asthma and
preventive care, and teaching
ABOUT THE RESIDENCY
“Was here multiple times [having
done several clinical rotations
here] and was very eager to
join [following his cousin, Dr.
Sharatkumar R. Rokkam, who
works as an attending after
completing a residency program
here]. It’s been a very good
experience.”
ABOUT THE RESIDENCY
“The training was very intense here.
I loved it. It was a great experience
working as part of a team in the
ED and in the family medicine
clinic, to work in both an acute and
chronic setting. The teamwork and
camaraderie have been memorable.
When someone needs help,
everyone pitches in. The training
has provided me with so many
opportunities.”
ABOUT THE RESIDENCY
“Small and beautiful. You get to
know everyone and the faculty
is very supportive. From the
beginning, it felt like a perfect fit.”
C
ould those childhood symptoms
consistent with Attention Deficit
Hyperactive Disorder (ADHD), actually
be suggestive of a sleep disorder?
“The symptoms of ADHD and sleep
deprivation due to obstructive sleep
apnea (OSA) are often very similar,” says
Dr. Mediha Ibrahim, a fellowship-trained
sleep expert and director of the Center
for Sleep Medicine at SBH. “A child who
is sleep-deprived can display problems
like inattentiveness, hyperactivity, mood
problems and disruptive behavior that
can be mistaken for ADHD.”
It is estimated that two to four percent
of American children between the ages
of two and eight years old have OSA –
and as many as 25 percent of children
diagnosed with ADHD may actually
have symptoms of OSA (with learning
and behavior problems a consequence
of their sleep disorder). OSA occurs
when the child’s airways are blocked for
seconds or even minutes due to any one
of a number of different reasons (most
often enlarged adenoids, tonsillitis,
allergic reactions, asthma, infection or
injury). Snoring, waking up multiple
times, gasping for air, difficulty waking
up are all common signs.
Dr. Ibrahim encourages pediatricians
to ask parents about their child’s sleeping
habits before diagnosing a child with
ADHD. At SBH, this is done routinely.
Should a sleep problem be discerned, a
polysomnography (sleep study) with the
Sleep Center is recommended before
exploring medication or behavior therapy.
A recent study conducted by the
Department of Pediatrics at SBH
found a significant association
between inattention and hyperactivity as
measured by the Conners' score
and sleep latency (the length of time
it takes to accomplish the transition
from full wakefulness to sleep), sleep
efficiency, and percent of sleep time
spent in REM even when adjusted
for age and BMI.
A polysomnography performed in a sleep
center is the only tool for a definitive
diagnosis and assessment of the severity
of pediatric OSA. Conducted during an
overnight stay at the hospital, with the
child accompanied by a parent or guardian,
the study provides a detailed look at the
child’s sleep problem, examining the
patient’s brainwaves, eye movement and
respiratory pattern while asleep.
The first line of treatment for OSA
is removal of the child’s tonsils and
adenoids. This will resolve symptoms
in an estimated 85 percent of cases. If
this is not effective, then a CPAP mask
(continuous positive airway pressure
therapy) may be recommended.
According to Dr. Ibrahim, the right
diagnosis is important, as medication
taken for ADHD can exacerbate OSA.
Lack of sleep can also have health and
development implications that can
adversely affect a child’s development.
This can include memory problems, lack
of cognitive growth, decreased ability to
learn, and lower IQ.
While ADHD symptoms persist for
some children, improvement in the
child’s OSA may allow for treatment
of ADHA with reduced medication.
RESEARCH
Is It ADHD or a Sleep Disorder?
By Steven Clark
20
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SUMMER 2017
