SYMPTOMS OF SLEEP DISORDERS, INATTENTION, AND HYPERACTIVITY IN CHILDREN

Children with sleep disorders are often inattentive or hyperactive, an d some carry a diagnosis of attention deficit/hyperactivity disorder ( ADHD) until their sleep disorder is detected. However, the potential b ehavioral impact of undiagnosed sleep disorders is not known. We sough t to determine whether children with higher levels of inattention and hyperactivity more frequently have symptoms of sleep-related breathing disorders (SRBDs) or periodic limb movement disorder (PLMD). We surve yed parents of 2-18-year-old patients at a child psychiatry clinic (n = 70) and a general pediatrics clinic (n = 73) to assess the children' s behavior, snoring, complaints of restless legs at night, and daytime sleepiness. A validated pediatric sleep questionnaire provided the ex planatory variables, and a scale for inattention and hyperactivity, de rived from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), provided the dependent variable. Habitual snorin g was more frequent (33%) among children who carried a diagnosis of AD HD than among the other children at the psychiatry or general pediatri c clinics (11 and 9%, respectively, chi-square test, p = 0.01). Snorin g scores, derived from six snoring-and SRBD-related question items, we re associated with higher levels of inattention and hyperactivity. The complaint of restless legs and a composite score for daytime sleepine ss showed some evidence, though less consistent, of an association wit h inattention and hyperactivity. The association of snoring with inatt ention and hyperactivity suggests that SRBDs and perhaps other sleep d isorders could be a cause of inattention and hyperactivity in some chi ldren. If a causal effect is present, our data suggest that 81% of hab itually snoring children who have ADHD-25% of all children with ADHD-c ould have their ADHD eliminated if their habitual snoring and any asso ciated SRBD were effectively treated.