Nguyen-Thi-Phuong Mai, Nguyen-Thi-Thanh Mai, Nguyen-Thi-Dieu Thuy, Duong-Quy Sy
Department of Pediatric, Hanoi Medical University, Hanoi, Vietnam.
Department of Psychiatry, Viet Nam National Children's Hospital, Hanoi, Vietnam.
Pulm Ther. 2025 Mar;11(1):69-80. doi: 10.1007/s41030-024-00286-8. Epub 2025 Jan 14.
Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder among children with attention deficit hyperactivity disorder (ADHD). This study aims to determine the prevalence of OSA in children with ADHD, compare the differences in clinical characteristics between children with ADHD-OSA and those without OSA (ADHD-nonOSA), and to identify the correlation between OSA and ADHD in children.
This cross-sectional descriptive study was conducted on 524 children with ADHD, aged 6-12 years, at the Vietnam National Children's Hospital from October 2022 to September 2023. Respiratory polygraphy was used to determine the prevalence of OSA in this study population; clinical data of children with ADHD-OSA and ADHD-nonOSA were collected and analyzed in each group. The severity of ADHD symptoms was measured by the Vanderbilt ADHD Parent Diagnosis Rating Scale (VADPRS questionnaire), and the severity of OSA was defined by Apnea-Hypopnea Index (AHI).
The prevalence of OSA in children with ADHD was 23.3%, with the majority of moderate-to-severe OSA. Significant differences were observed in sleep onset time, total sleep duration, and various sleep-related behaviors, such as bedtime resistance and difficulty waking up in the morning, between children with ADHD-OSA and ADHD-nonOSA (p < 0.001, p < 0.001, p < 0.05, and p < 0.005, respectively). The severity levels of inattention, hyperactivity, and behavioral disorders were significantly higher in children with moderate-to-severe OSA compared to those with mild OSA (p < 0.005, p < 0.005, and p < 0.001, respectively). There were significant correlations between AHI with inattention scores (r = 0.677; p < 0.0001), hyperactivity scores (r = 0.438; p = 0.05), behavioral disorder scores (r = 0.342; p < 0.05), and anxiety/depression scores (r = 0.357; p < 0.05) measured by VADPRS questionnaire.
OSA is a common sleep-related breathing disorder in children with ADHD, which might exacerbate ADHD symptoms. Thus, screening of OSA in children with ADHD is essential during the management of ADHD in this population.
阻塞性睡眠呼吸暂停（OSA）是注意力缺陷多动障碍（ADHD）儿童中常见的与睡眠相关的呼吸障碍。本研究旨在确定ADHD儿童中OSA的患病率，比较ADHD-OSA儿童与无OSA的ADHD儿童（ADHD-非OSA）的临床特征差异，并确定儿童中OSA与ADHD之间的相关性。
本横断面描述性研究于2022年10月至2023年9月在越南国家儿童医院对524名6至12岁的ADHD儿童进行。本研究采用呼吸多导记录仪来确定该研究人群中OSA的患病率；收集并分析每组中ADHD-OSA和ADHD-非OSA儿童的临床数据。ADHD症状的严重程度通过范德比尔特ADHD家长诊断评定量表（VADPRS问卷）进行测量，OSA的严重程度由呼吸暂停低通气指数（AHI）定义。
ADHD儿童中OSA的患病率为23.3%，大多数为中重度OSA。ADHD-OSA儿童与ADHD-非OSA儿童在入睡时间、总睡眠时间以及各种与睡眠相关的行为，如就寝时间抗拒和早晨醒来困难等方面存在显著差异（分别为p<0.001、p<0.001、p<0.05和p<0.005）。与轻度OSA儿童相比，中重度OSA儿童的注意力不集中、多动和行为障碍的严重程度显著更高（分别为p<0.005、p<0.005和p<0.001）。通过VADPRS问卷测量，AHI与注意力不集中得分（r=0.677；p<0.0001）、多动得分（r=0.438；p=0.05）、行为障碍得分（r=0.342；p<0.05）以及焦虑/抑郁得分（r=0.357；p<0.05）之间存在显著相关性。
OSA是ADHD儿童中常见的与睡眠相关的呼吸障碍，可能会加重ADHD症状。因此，在该人群ADHD的管理过程中，对ADHD儿童进行OSA筛查至关重要。
