A Study to Assess the Relationship between Attention Deficit Hyperactivity Disorder and Obstructive Sleep Apnea in Adults.

Sean Hesselbacher,Joseph Varon,Alishah A Suleman,Akshar A Aiyer,Salim R Surani

doi:10.7759/cureus.5979

Abstract

The association between obstructive sleep apnea (OSA) and attention deficit hyperactivity disorder (ADHD) is well-established in children. However, there is a paucity of literature regarding this association in adults. The aim of this study was to determine if ADHD is more common in adult patients with OSA. All patients referred to a sleep center for sleep evaluation were administered the Adult ADHD Self-Report Scale and diagnostic polysomnogram. The ADHD screen is considered positive if 4 of 6 questions in part A of the screening questionnaire were answered abnormally. The study population consisted of 194 participants, predominantly male (62%), Caucasian (54%), and Hispanic (44%). OSA was identified in 160 (83%) of participants, with 116 (60%) having moderate to severe OSA. The ADHD screen was positive in 37 (19%) of participants. There was no significant association between the severity of OSA and presence of ADHD symptoms. Patients with OSA who screened positive for ADHD had higher Epworth Sleepiness Scale scores than those that did not. These data suggest that ADHD is more prevalent in patients with OSA, but do not demonstrate a relationship between OSA severity and ADHD symptoms. Interestingly, sleepiness is more prominent in patients with ADHD.

Highlights

Obstructive sleep apnea (OSA) is a common disease with prevalence ranging between 2-7% in the middle age population with apnea hypopnea index (AHI) >5, and is even higher among the elderly and in patients with cardiovascular complications and metabolic syndrome [1,2,3,4]
There was no significant association between the severity of obstructive sleep apnea (OSA) and presence of attention deficit hyperactivity disorder (ADHD) symptoms
The presence of a positive ADHD screen was not associated with any significant difference in AHI (25.7±22.8, N=37 vs. 30.6±28.5, N=157; P=0.47)

Summary

Introduction

Obstructive sleep apnea (OSA) is a common disease with prevalence ranging between 2-7% in the middle age population with apnea hypopnea index (AHI) >5, and is even higher among the elderly and in patients with cardiovascular complications and metabolic syndrome [1,2,3,4]. OSA has been associated with impaired daytime performance, public health consequences, general health complications, and comorbid psychiatric conditions [5,6,7,8]. Studies have correlated the presence and severity of OSA with ADHD in the pediatric population, though there has been very little work reported in adults. We attempted to examine the associations between ADHD and OSA in a population of adults referred for sleep testing

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Conclusion