Snoring and Attention deficit hyperactivity disorder in Children in Qom, Iran
DOI:
https://doi.org/10.22122/cdj.v3i1.83Keywords:
Snoring, Attention deficit hyperactivity disorder (ADHD), Behavioral Disorders, Children, Sleep ApneaAbstract
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is an important and common problem in children
(4-12%) which affects their daily activities and quality of life. About 1-2% of children suffer from sleep apnea with a common symptom of snoring which might cause behavioral disorders due to the lower quality of sleep. In the present study, we aim to determine the association between snoring and ADHD.
METHODS: In this case control study, we enrolled 100 children of 2-12 years who snored as the case group and 100 healthy peers as the control group. Snoring and behavioral problems were assessed by the standard questionnaires of the Berlin Questionnaire and Behavioral Disorder Questionnaire [DSM-IV], respectively.
RESULTS: The mean age, height, and weight of children were 6.81 years, 116.11 cm, and 25.39 Kg, respectively. In addition, 53.5% of participants of both groups were boys. A significant relationship was found between snoring and ADHD and its subtypes (P < 0.001).
CONCLUSION: Increasing the information of parents and colleagues on the association of snoring with behavioral disorders might assist in early diagnosis and treatment.
References
Montgomery-Downs HE, O'Brien LM, Holbrook CR, Gozal D. Snoring and sleep-disordered breathing in young children: subjective and objective correlates. Sleep 2004; 27(1): 87-94.
Gislason T, Benediktsdottir B. Snoring, apneic episodes, and nocturnal hypoxemia among children 6 months to 6 years old. An epidemiologic study of lower limit of prevalence. Chest 1995; 107(4): 963-6.
Owen GO, Canter RJ, Robinson A. Snoring, apnoea and ENT symptoms in the paediatric community. Clin Otolaryngol Allied Sci 1996; 21(2): 130-4.
Ferreira AM, Clemente V, Gozal D, Gomes A, Pissarra C, Cesar H, et al. Snoring in Portuguese primary school children. Pediatrics 2000; 106(5): E64.
O'Brien LM, Holbrook CR, Mervis CB, Klaus CJ, Bruner JL, Raffield TJ, et al. Sleep and neurobehavioral characteristics of 5- to 7-year-old children with parentally reported symptoms of attention-deficit/hyperactivity disorder. Pediatrics 2003; 111(3): 554-63.
Weissbluth M, Davis AT, Poncher J, Reiff J. Signs of airway obstruction during sleep and behavioral, developmental, and academic problems. J Dev Behav Pediatr 1983; 4(2): 119-21.
American Academy of Sleep Medicine. The International Classification of Sleep Disorders: Diagnostic and Coding Manual. Darien, IL: American Academy of Sleep Medicine; 2005.
Marcus CL, Hamer A, Loughlin GM. Natural history of primary snoring in children. Pediatr Pulmonol 1998; 26(1): 6-11.
Topol HI, Brooks LJ. Follow-up of primary snoring in children. J Pediatr 2001; 138(2): 291-3.
Brown RT, Freeman WS, Perrin JM, Stein MT, Amler RW, Feldman HM, et al. Prevalence and assessment of attention-deficit/hyperactivity disorder in primary care settings. Pediatrics 2001; 107(3): E43.
Froehlich TE, Lanphear BP, Epstein JN, Barbaresi WJ, Katusic SK, Kahn RS. Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Arch Pediatr Adolesc Med 2007; 161(9): 857-64.
Talaei A, Mokhber N, Abdollahian E, Bordbar MR, Salari E. Attention deficit/hyperactivity disorder: a survey on prevalence rate among male subjects in elementary school (7 to 9 years old) in Iran. J Atten Disord 2010; 13(4): 386-90.
Ghanizadeh A. Distribution of symptoms of attention deficit-hyperactivity disorder in schoolchildren of Shiraz, south of Iran. Arch Iran Med 2008; 11(6): 618-24.
Ardalan G, Farhud D, Shahmohammadi D. Hyperactivity, attention and concentration deficit in preschool children. Iran J Pediatr 2002; 12(4): 53-6.
Hebrani P, Abdolahian E, Behdani F, Vosoogh I, Javanbakht A. The prevalence of attention deficit hyperactivity disorder in preschool-age children in Mashhad, north-East of Iran. Arch Iran Med 2007; 10(2): 147-51.
Polanczyk G, Jensen P. Epidemiologic considerations in attention deficit hyperactivity disorder: a review and update. Child Adolesc Psychiatr Clin N Am 2008; 17(2): 245-60, vii.
Carlsson ML. On the role of cortical glutamate in obsessive-compulsive disorder and attention-deficit hyperactivity disorder, two phenomenologically antithetical conditions. Acta Psychiatr Scand 2000; 102(6): 401-13.
Castellanos FX, Lee PP, Sharp W, Jeffries NO, Greenstein DK, Clasen LS, et al. Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. JAMA 2002; 288(14): 1740-8.
American Psychiatric Association, Task Force on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 1994.
Guilleminault C, Winkle R, Korobkin R, Simmons B. Children and nocturnal snoring: evaluation of the effects of sleep related respiratory resistive load and daytime functioning. Eur J Pediatr 1982; 139(3): 165-71.
Dahl RE, Pelham WE, Wierson M. The role of sleep disturbances in attention deficit disorder symptoms: a case study. J Pediatr Psychol 1991; 16(2): 229-39.
Kotagal S, Hartse KM, Walsh JK. Characteristics of narcolepsy in preteenaged children. Pediatrics 1990; 85(2): 205-9.
Ali NJ, Pitson D, Stradling JR. Sleep disordered breathing: effects of adenotonsillectomy on behaviour and psychological functioning. Eur J Pediatr 1996; 155(1): 56-62.
Walters AS, Mandelbaum DE, Lewin DS, Kugler S, England SJ, Miller M. Dopaminergic therapy in children with restless legs/periodic limb movements in sleep and ADHD. Dopaminergic Therapy Study Group. Pediatr Neurol 2000; 22(3): 182-6.
Montgomery-Donws HE, Holbrook CR, Gozal D. Snoring prevalence among preschoolers at-risk for learning difficulties: a preliminary report. Sleep 2002; 25: A230.
Blunden S, Lushington K, Kennedy D, Martin J, Dawson D. Behavior and neurocognitive performance in children aged 5-10 years who snore compared to controls. J Clin Exp Neuropsychol 2000; 22(5): 554-68.
Guilleminault C, Pelayo R. Sleep-disordered breathing in children. Ann Med 1998; 30(4): 350-6.
Schechter MS. Technical report: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2002; 109(4): e69.
Chervin RD, Archbold KH, Dillon JE, Panahi P, Pituch KJ, Dahl RE, et al. Inattention, hyperactivity, and symptoms of sleep-disordered breathing. Pediatrics 2002; 109(3): 449-56.
Philipsen A, Hornyak M, Riemann D. Sleep and sleep disorders in adults with attention deficit/hyperactivity disorder. Sleep Med Rev 2006; 10(6): 399-405.
Silvestri R, Gagliano A, Arico I, Calarese T, Cedro C, Bruni O, et al. Sleep disorders in children with Attention-Deficit/Hyperactivity Disorder (ADHD) recorded overnight by video-polysomnography. Sleep Med 2009; 10(10): 1132-8.
Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 1999; 131(7): 485-91.
Netzer NC, Hoegel JJ, Loube D, Netzer CM, Hay B, Alvarez-Sala R, et al. Prevalence of symptoms and risk of sleep apnea in primary care. Chest 2003; 124(4): 1406-14.
Amra B, Nouranian E, Golshan M, Fietze I, Penzel T. Validation of the persian version of berlin sleep questionnaire for diagnosing obstructive sleep apnea. Int J Prev Med 2013; 4(3): 334-9.
Vaz AP, Drummond M, Mota PC, Severo M, Almeida J, Winck JC. Translation of Berlin Questionnaire to Portuguese language and its application in OSA identification in a sleep disordered breathing clinic. Rev Port Pneumol 2011; 17(2): 59-65.
Barkley RA. Attention-deficit Hyperactivity Disorder: A Clinical Workbook. New York, NY: Guilford Press; 1991.
Barkley RA, Murphy KR. Attention-deficit Hyperactivity Disorder: A Clinical Workbook. 2nd ed. New York, NY: Guilford Press; 1998.
Chervin RD, Ruzicka DL, Archbold KH, Dillon JE. Snoring predicts hyperactivity four years later. Sleep 2005; 28(7): 885-90.
Chervin RD, Dillon JE, Bassetti C, Ganoczy DA, Pituch KJ. Symptoms of sleep disorders, inattention, and hyperactivity in children. Sleep 1997; 20(12): 1185-92.
Gozal D, Daniel JM, Dohanich GP. Behavioral and anatomical correlates of chronic episodic hypoxia during sleep in the rat. J Neurosci 2001; 21(7): 2442-50.
LeBourgeois MK, Avis K, Mixon M, Olmi J, Harsh J. Snoring, sleep quality, and sleepiness across attention-deficit/hyperactivity disorder subtypes. Sleep 2004; 27(3): 520-5.
Chervin RD, Archbold KH. Hyperactivity and polysomnographic findings in children evaluated for sleep-disordered breathing. Sleep 2001; 24(3): 313-20.
Kaemingk KL, Pasvogel AE, Goodwin JL, Mulvaney SA, Martinez F, Enright PL, et al. Learning in children and sleep disordered breathing: findings of the Tucson Children's Assessment of Sleep Apnea (tuCASA) prospective cohort study. J Int Neuropsychol Soc 2003; 9(7): 1016-26.
Gottlieb DJ, Chase C, Vezina RM, Heeren TC, Corwin MJ, Auerbach SH, et al. Sleep-disordered breathing symptoms are associated with poorer cognitive function in 5-year-old children. J Pediatr 2004; 145(4): 458-64.
Li AM, Au CT, So HK, Lau J, Ng PC, Wing YK. Prevalence and risk factors of habitual snoring in primary school children. Chest 2010; 138(3): 519-27.
Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2002; 109(4): 704-12.
Gottlieb DJ, Vezina RM, Chase C, Lesko SM, Heeren TC, Weese-Mayer DE, et al. Symptoms of sleep-disordered breathing in 5-year-old children are associated with sleepiness and problem behaviors. Pediatrics 2003; 112(4): 870-7.
