Associations among high risk for sleep-disordered breathing, related risk factors, and attention deficit/hyperactivity symptoms in elementary school children
Kyoung Min Kim 1, 6*, Jee Hyun Kim 2, Dohyun Kim 3, Myung Ho Lim 4, 6, Hyunjoo Joo 5, Seung-Jin Yoo 6, Eunjung Kim 6, Mina Ha 5, Ki-Chung Paik 1, 6, Hojang Kwon 5, 6
1Department of Psychiatry, Dankook University College of Medicine, Cheonan, Republic of Korea, 2Department of Neurology, Dankook University College of Medicine, Dankook University Hospital, Cheonan, Republic of Korea, 3Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea, 4Department of Psychology, College of Public Human Resources, Dankook University, Cheonan, Republic of Korea, 5Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea, 6Environmental Health Center, Dankook University Medical Center, Cheonan, Republic of Korea
Received: August 17, 2019; Revised: December 18, 2019; Accepted: January 3, 2020; Published online: January 3, 2020.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: Habitual snoring is a common problem in children. We evaluated the association between a high risk for sleep-disordered breathing and attention deficit/hyperactivity symptoms.
Methods: Parents of 13,560 children aged 6 to 12 years responded to questionnaires including items on habitual snoring and the Korean attention deficit/hyperactivity disorder rating scale. The snoring score comprised the number of “yes” responses to habitual-snoring items, and a high risk for sleep-disordered breathing was defined as a snoring score ≥2.
Results: The odds ratio (OR) of a high risk for sleep-disordered breathing was significantly higher in boys (odds ratio=1.47; p<0.001), overweight children (odds ratio=2.20; p<0.001), and children with current secondhand-smoking exposure (odds ratio=1.38; p<0.001). The Korean attention deficit/hyperactivity disorder rating scale score increased significantly with the snoring score (0 vs 1, B=1.56, p<0.001; 0 vs 2, B=2.44, p<0.001; 0 vs 3, B=2.48, p<0.001; 0 vs 4, B=3.95; p<0.001).
Conclusion: Our study confirms several risk factors of sleep-disordered breathing, namely male sex, overweight, and exposure to tobacco smoking, and found a positive association between habitual snoring and attention deficit/hyperactivity symptoms.
Keywords: sleep-disordered breathing, ADHD, risk factors, elementary school children


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