Affiliations: Drexel University School of Medicine, Philadelphia, PA, USA | Penn State Milton Hershey Medical Center, Hershey, PA, USA | University of Louisville School of Medicine, Louisville, KY, USA
Note: [] Corresponding author: Dr. Karim Sedky, Department of Psychiatry,
Friends Hospital, Drexel University, 4641 Roosevelt Boulevard, Philadelphia, PA
19124, USA. Tel.: +1 215 831 4053; Fax: +1 215 831 4020; E-mail: [email protected]
Abstract: Children and adolescents suffering from attention deficit
hyperactivity disorder (ADHD) and/or sleep disordered breathing (SDB) may
present with similar symptoms, including inattention, irritability, and
hyperactivity. SDB is under-diagnosed in young people and is not often
recognized in patients with ADHD; we hypothesize that treating sleep disordered
breathing in ADHD patients may diminish symptoms and reduce ADHD-focused
pharmacotherapy. A Medline search was performed using the criteria for ADHD and
SDB. English language publications through January, 2012 were surveyed.
Correlation between these two disorders is confounded due to methodological
errors in research. The investigations lack consistency due to studies with
small sample size, a dearth of diagnostic polysomnography (PSG) to detect SDB,
varying definitions for the apnea/hypopnea index, and lack of uniform
evaluations to diagnose ADHD. Despite methodological inconsistencies, the data
suggests that treating SDB may have a productive impact on treatment outcomes
in children with mild ADHD. Patients with ADHD symptomatology should receive
SDB screening. In those with comorbid SDB and ADHD, an adenotonsillectomy (AT)
may improve the prognosis. Treatment of SDB coexisting with ADHD aims to
decrease clinical symptoms, reduce pharmacotherapy, and promote better health.
