ADHD Pathway - its missing a crucial biological link

Following the publication of the second part of the NHS England ADHD Taskforce Report yesterday, as a Buteyko Breath Coach working with children, I strongly support the joined-up approach that is called for, but I believe the pathway is missing a CRUCIAL biological link: how children breathe and sleep.https://www.england.nhs.uk/2025/11/nhs-england-responds-to-adhd-taskforce-final-report/

Asking a few simple questions that could make a big difference:

• Does the child snore or breathe through their mouth during sleep?

• Are there signs of poor nasal airflow or chronic congestion?

• Is daytime breathing shallow, audible or irregular, especially during concentration or stress?

  

The report makes NO reference to sleep nor airway health at all, depsite some Doctors claiming over 50% of ADHD diagnosis could be misdiagnosed. https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.instagram.com/reel/DQbXyFpjCN2/&ved=2ahUKEwjEmLWi_N-QAxXGSEEAHVjkKNgQwqsBegQIDxAB&usg=AOvVaw0T_b0CHhfGw5RCiQio2ZQV

Research shows that mouth breathing and disrupted sleep can impair memory, focus, and emotional regulation, all KEY concerns in ADHD. Studies show that poor nasal breathing and sleep fragmentation reduce executive function and academic performance, yet the new pathway makes no mention of breathing or sleep quality at all.

The Taskforce emphasises “early support and collaboration between education and healthcare,” But we must include breathing and sleep in that conversation. A child who can’t breathe well can’t focus well; no matter how skilled their teacher or how supportive their environment.

I help schools and families recognise early signs of dysfunctional breathing and teach playful, evidence-based exercises that support calm, nasal breathing with the help of Susie Sloth. It’s simple, low-cost and could fit perfectly within the Taskforce’s preventative model.

Checking children’s breathing will flag physiological factors that mimic or worsen ADHD-type symptoms. Addressing them early could reduce misdiagnosis and improve both focus and wellbeing. This clip follows one family's journey as Connor's life trajectory is dramatically transformed. https://youtu.be/Sk5qsmRyVcE?si=uVVIF-5xx9eLV5H9

Dr Louise Oliver and I have launched an online course to help professionals and parents understand more about this overlooked and crucial piece of child development, health and education. https://www.benefitsofbetterbreathing.co.uk/childrens-course

There are numerous and highly credible research papers (links below) that support the notion that breathing dysfunction, sleep‑disordered breathing (SDB) may be a contributory factor in children who are diagnosed with Attention‑Deficit/Hyperactivity Disorder (ADHD)‑type symptoms. 

Patrick Mckeown, a renowned world breathing educator explains how chronic mouth breathing as a child led to poor sleep, hindered concentration, and impacted his academic performance, ultimately leading to his interest in the Buteyko breathing method. Listen in here https://drchatterjee.com/how-breathing-through-your-nose-will-change-your-life-with-patrick-mckeown/

We need a quiet breathing revolution; breathing IS the missing link for a number of children.

When a body such as an NHS Taskforce makes no mention of it whatsoever, we've got our work cut out that's for sure. But the tide is turning, as more parents, teachers and clinicians see the difference a child's breathing can make...awareness is beginning to shift.

Research Studies:

“Deep learning for sleep analysis on children with mouth breathing events” — Frontiers in Sleep, 2023. Link  

“Neurocognitive outcomes of children with sleep‑disordered breathing (SDB): a systematic review and meta‑analysis” — 2022. Abstract link  

“Assessment of the Effect of Rapid Maxillary Expansion on Nasal Breathing and Sleep‑Disordered Breathing in Children” — 2025. Link  

Sleep Difficulties and Symptoms of Attention‑deficit Hyperactivity Disorder in Children with Mouth Breathing (Kalaskar et al., 2021) – This cross‑sectional study of 100 children ages 7‑12 who were mouth breathers found high rates of sleep‑disordered breathing and ADHD‑type symptoms (73% inattention in school, 66% trouble waiting turn) and found that sleep duration/daytime sleepiness correlated with hyperactivity/inattention. Link:https://pmc.ncbi.nlm.nih.gov/articles/PMC8645617/

Sleep Disordered Breathing and Risk for ADHD: Review of Supportive Evidence and Proposed Underlying Mechanisms (2023) – A review article that states: “Existing studies suggest that co‑occurrence of SDB and ADHD is as high as 50%, with frequent overlap of clinical symptoms such as distractibility and inattention.” Link:https://pubmed.ncbi.nlm.nih.gov/38353411/