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Apnea-hypopnea indices and snoring in children diagnosed with ADHD: a matched case-control study

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Abstract

Objectives

To measure apnea-hypopnea indices and snoring in children diagnosed with attention-deficit hyperactivity disorder (ADHD) in a case-control design. Additionally, the study design allowed us to investigate whether or not methylphenidate had any effect on breathing variables.

Methods

Twenty-eight children (22 boys) aged 6–12 years meeting diagnostic criteria for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV ADHD were studied together with matched controls. Two nights of polysomnography (PSG) were conducted that included recordings of snoring waveforms. A randomly assigned 48-h on-off medication protocol was used for ADHD children. Control children’s recordings were matched for PSG night, but medication was not used. A low apnea-hypopnea index (AHI) threshold of >1event per hour was used to define sleep-disordered breathing (SDB) because of a clinical relevance in ADHD.

Results

Categorical analyses for paired binary data showed no significant differences between control and ADHD children for presence of an AHI >1 or snoring. Variables were extracted from a significantly shorter total sleep time (67 min) on the medication night in children with ADHD. Eight (28%) control and 11 (40%) ADHD children snored >60 dB some time during the night. Methylphenidate had no effect on central apneas, AHI, desaturation events, or any snoring data.

Conclusions

Our PSG findings show no strong link between ADHD and SDB although our findings could be limited by a small sample size. Findings from PSG studies in the literature argue both for and against an association between ADHD and SDB. Our results suggest medication is not a factor in the debate.

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Acknowledgments

We are grateful to Amanda Phillips for research assistance. We thank the children and their parents/guardians who participated in this study. The project was supported by a grant from the Health Research Council of New Zealand.

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Authors and Affiliations

  1. Department of Women’s and Children’s Health, University of Otago, P.O. Box 913, Dunedin, New Zealand

    Barbara C. Galland & Barry J. Taylor

  2. Department of Psychology, University of Otago, Dunedin, New Zealand

    E. Gail Tripp

  3. Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand

    Andrew Gray

Authors
  1. Barbara C. Galland
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  2. E. Gail Tripp
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  3. Andrew Gray
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  4. Barry J. Taylor
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Correspondence to Barbara C. Galland.

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Galland, B.C., Tripp, E.G., Gray, A. et al. Apnea-hypopnea indices and snoring in children diagnosed with ADHD: a matched case-control study. Sleep Breath 15, 455–462 (2011). https://doi.org/10.1007/s11325-010-0357-0

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  • DOI: https://doi.org/10.1007/s11325-010-0357-0

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