ADHD-LIKE SYMPTOMS IN CHILDREN AFFECTED BY OBSTRUCTIVE SLEEP APNEA SYNDROME: A CASE-CONTROL STUDY

FRANCESCO PRECENZANO*, MARIA RUBERTO**, LUCIA PARISI***, MARGHERITA SALERNO****, AGATA MALTESE***, ILARIA D’ALESSANDRO*, IMMACOLATA DELLA VALLE*, GENNARO VISCO*, ROSARIA MARTINA MAGLIULO*, GIOVANNI MESSINA*****, MICHELE ROCCELLA***

*Clinic of Child and Adolescent Neuropsychiatry; Headache Center for children and adolescents, Department of Mental Health and Physical and Preventive Medicine, Second University of Naples - **Department of Medical-Surgical and Dental Specialties, Second University of Naples - ***Department of Psychological, Pedagogical and Educational Sciences, University of Palermo, Italy - ****Sciences for Mother and Child Health Promotion, University of Palermo, Italy - *****Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy #Francesco Precenzano and Maria Ruberto equally contributed to the manuscript

Introduction: ADHD is characterized by inattention, hyperactivity, impulsivity, or a combination of these symptoms. Sleep disorders may be considered as a not secondary underlying cause of ADHD and growing evidence evidenced that obstructive sleep apnea syndrome (OSA) symptoms may overlap ADHD’s ones. Aim of the present study is verifying the presence of ADHD-like symptoms in other frequent condition such as sleep-related breathing disorders in pediatric age.

Materials and methods: 34 children (19 males and 15 females) aged 6-10 years (mean age 9.706 ± 3.434) with polysomnographic diagnosis of OSA, according to ICSD-3 criteria, were recruited. Control group was composed by 89 typical developing children (47 males, 42 females) (mean age 9,528 ± 3,351). The Conners’ Rating Scale– Revised (CRS-R) test was administered to mothers to assess their children’s behavior.

Results: The two groups are comparable for age (p = 0.794) and sex distribution (p = 0.918). Subjects affected by OSA present higher scores in pathological range in all scales of CRS-R than controls (Table 1).

Conclusions: Scientific and clinical evidences tend to stress the similarities between ADHD and OSA effects/comorbidities in pediatric age, suggesting sleep screening as mandatory before starting stimulant drugs treatment.