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Surgical treatment of mild obstructive sleep apnea in school-aged children diagnosed with attention-deficit/hyperactivity disorder and mild obstructive sleep apnea resulted in big improvements in ADHD symptoms, compared with those treated with methylphenidate alone, investigators reported.
“Recognition and surgical treatment of underlying mild sleep-disordered breathing in children with ADHD may prevent unnecessary long-term methylphenidate usage and the potential side effects associated with drug intake,” Dr. Yu-Shu Huang, of Chang Gung Memorial University Hospital, Taipei, Taiwan, and colleagues wrote (Sleep Med. 2007;8:18–30).
Dr. Huang and colleagues examined the effect of three treatment options on 66 children with ADHD and mild obstructive sleep apnea confirmed by polysomnography treatment with methylphenidate, under supervision of the child's psychiatrist; systematic adenotonsillectomy, in children with adenotonsil hypertrophy confirmed by a pediatric otolaryngologist; or a wait-and-see approach, with regular follow-up but no treatment.
The study population was recruited from among school children, aged 6–12 years, who were referred to a child psychiatry clinic for behavioral problems suggestive of ADHD. All children received a thorough clinical evaluation, and an ear, nose, and throat specialist performed an otolaryngolic examination. Children were given comprehensive neuropsychological tests, including the Test of Variables of Attention (TOVA), to evaluate AHDH. Parents completed questionnaires concerning their children's behavior (Child Behavior Checklist) and quality of life in children with obstructive sleep disorders (OSA-18).
All 66 children with ADHD had apnea-hypopnea index scores between 1 and 5 (mild apnea) before treatment. Twenty-seven children received methylphenidate, 25 were given an adenotonsillectomy, and 14 had no treatment.
Both the adenotonsillectomy group and the methylphenidate group had far better posttreatment scores on neuropsychological assessments of ADHD than did the no-treatment group or the control group. “The results support the need to treat OSA first when identified in the presence of an AHDH clinical presentation,” Dr. Huang wrote.
Surgical treatment of mild obstructive sleep apnea in school-aged children diagnosed with attention-deficit/hyperactivity disorder and mild obstructive sleep apnea resulted in big improvements in ADHD symptoms, compared with those treated with methylphenidate alone, investigators reported.
“Recognition and surgical treatment of underlying mild sleep-disordered breathing in children with ADHD may prevent unnecessary long-term methylphenidate usage and the potential side effects associated with drug intake,” Dr. Yu-Shu Huang, of Chang Gung Memorial University Hospital, Taipei, Taiwan, and colleagues wrote (Sleep Med. 2007;8:18–30).
Dr. Huang and colleagues examined the effect of three treatment options on 66 children with ADHD and mild obstructive sleep apnea confirmed by polysomnography treatment with methylphenidate, under supervision of the child's psychiatrist; systematic adenotonsillectomy, in children with adenotonsil hypertrophy confirmed by a pediatric otolaryngologist; or a wait-and-see approach, with regular follow-up but no treatment.
The study population was recruited from among school children, aged 6–12 years, who were referred to a child psychiatry clinic for behavioral problems suggestive of ADHD. All children received a thorough clinical evaluation, and an ear, nose, and throat specialist performed an otolaryngolic examination. Children were given comprehensive neuropsychological tests, including the Test of Variables of Attention (TOVA), to evaluate AHDH. Parents completed questionnaires concerning their children's behavior (Child Behavior Checklist) and quality of life in children with obstructive sleep disorders (OSA-18).
All 66 children with ADHD had apnea-hypopnea index scores between 1 and 5 (mild apnea) before treatment. Twenty-seven children received methylphenidate, 25 were given an adenotonsillectomy, and 14 had no treatment.
Both the adenotonsillectomy group and the methylphenidate group had far better posttreatment scores on neuropsychological assessments of ADHD than did the no-treatment group or the control group. “The results support the need to treat OSA first when identified in the presence of an AHDH clinical presentation,” Dr. Huang wrote.
Surgical treatment of mild obstructive sleep apnea in school-aged children diagnosed with attention-deficit/hyperactivity disorder and mild obstructive sleep apnea resulted in big improvements in ADHD symptoms, compared with those treated with methylphenidate alone, investigators reported.
“Recognition and surgical treatment of underlying mild sleep-disordered breathing in children with ADHD may prevent unnecessary long-term methylphenidate usage and the potential side effects associated with drug intake,” Dr. Yu-Shu Huang, of Chang Gung Memorial University Hospital, Taipei, Taiwan, and colleagues wrote (Sleep Med. 2007;8:18–30).
Dr. Huang and colleagues examined the effect of three treatment options on 66 children with ADHD and mild obstructive sleep apnea confirmed by polysomnography treatment with methylphenidate, under supervision of the child's psychiatrist; systematic adenotonsillectomy, in children with adenotonsil hypertrophy confirmed by a pediatric otolaryngologist; or a wait-and-see approach, with regular follow-up but no treatment.
The study population was recruited from among school children, aged 6–12 years, who were referred to a child psychiatry clinic for behavioral problems suggestive of ADHD. All children received a thorough clinical evaluation, and an ear, nose, and throat specialist performed an otolaryngolic examination. Children were given comprehensive neuropsychological tests, including the Test of Variables of Attention (TOVA), to evaluate AHDH. Parents completed questionnaires concerning their children's behavior (Child Behavior Checklist) and quality of life in children with obstructive sleep disorders (OSA-18).
All 66 children with ADHD had apnea-hypopnea index scores between 1 and 5 (mild apnea) before treatment. Twenty-seven children received methylphenidate, 25 were given an adenotonsillectomy, and 14 had no treatment.
Both the adenotonsillectomy group and the methylphenidate group had far better posttreatment scores on neuropsychological assessments of ADHD than did the no-treatment group or the control group. “The results support the need to treat OSA first when identified in the presence of an AHDH clinical presentation,” Dr. Huang wrote.