The relationship between sleep-disordered breathing, sleep quality, and ADHD symptoms in children

Abstract

Many previous studies on children with sleep-disordered breathing (SDB) show that they have disrupted sleep. The consequences of disrupted sleep can significantly affect children´s everyday lives. The effects of sleep disruption can mimic the effects of attention deficit hyperactivity disorder (ADHD) on behavior and attention. Some studies have found a relationship between sleep disruption and ADHD symptoms in children but the findings are mixed. This study examined the relationship between objective sleep quality and SDB, and also examined if sleep disruption affects cognitive outcomes. The participants in the study were 105 Icelandic children (35.2% girls) aged 9-13 years. All participants performed overnight polysomnography (PSG) and cognitive tests (CPT). The parents answered questionnaires Five-to-fifteen (FTF) regarding their sleep and behavior. The results showed that children with SDB had significantly increased slow-wave sleep (SWS) compared to the control group without SDB. Other sleep parameters did not differ between the groups. When examining the outcome of the cognitive tests, children who did have disrupted sleep due to arousal did show some/strong indication of problems with impulsiveness. Sleep quality was not significantly different from other groups on the cognitive tests. When examining the outcome of the executive function there was no significant difference between the SDB group and the no SDB group. Although children do sleep well in general, sleep disruption can affect behavior and be associated with ADHD symptoms. It is important to be aware of children´s sleep because it can have multiple effects on their life.Keywords: sleep-disordered breathing, snoring, obstructive sleep apnea (OSA), children, sleep fragmentation, sleep architecture, ADHD symptoms