Association between Attention Deficit Hyperactivity Disorder and Obstructive Sleep Apnea in Children: A Systematic Review and Meta-Analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of longitudinal observational studies
PubMed 41910119 · doi:10.1177/10870547261426094
What was done
A systematic review and random-effects meta-analysis was conducted across PubMed, Embase, and SCOPUS (searched from inception to 1 December 2024) to evaluate the association between obstructive sleep apnea (OSA) and attention deficit hyperactivity disorder (ADHD) in pediatric populations. Included studies were longitudinal investigations involving children formally diagnosed with OSA or ADHD. Study quality was evaluated using the Newcastle-Ottawa Scale and evidence certainty was assessed using the GRADE framework. Pooled prevalence was calculated via random-effects meta-analysis, while other outcomes were synthesized descriptively.
What was found
Across 11 studies comprising 903 children: - The pooled prevalence of OSA in children with ADHD was 44% (95% CI [2%, 56%]). - Descriptive analysis showed that adenotonsillectomy for OSA consistently led to significant improvements in both OSA and ADHD symptoms.
Why it matters
Recognizing the frequent co-occurrence of OSA in pediatric ADHD points to the utility of screening for sleep-disordered breathing, as treating underlying airway obstruction may improve behavioral symptoms and potentially reduce reliance on pharmacological management.
Limits
The abstract reports a very wide confidence interval for pooled prevalence (95% CI [2%, 56%]), indicating considerable imprecision or heterogeneity. Treatment outcomes were reviewed only descriptively without meta-analytic pooling. The evidence base is restricted to longitudinal observational studies across a modest total sample size (903 participants), limiting causal inferences.
Cited by
- partial Children who mouth-breathe consistently have attention-deficit disorder (ADD) issues.