B31-09 Polysomnographic Findings in Children With Obstructive Sleep Apnea and ADHD in Children at a High-Altitude City

Abstract Rationale Obstructive sleep apnea (OSA) has been associated with attention deficit hyperactivity disorder (ADHD). However, few studies have explored this relationship in children living at high altitude (2500 meters above sea level) nor performed polysomnographic studies. This study aimed to describe clinical and Polysomnographic (PSG) characteristics of children evaluated for OSA and ADHD at a high-altitude city. Methods A cohort of 187 children underwent overnight polysomnography and psychological assessments for ADHD. Qualitative variables are presented in absolute and relative frequencies and quantitative variables in means, standard deviations, and ranges. Statistical significance was assessed using chi square and Kruskal-Wallis test Results The mean age was 7.8 ± 2.7 years. Participants were categorized into four groups: OSA without ADHD (n = 40), OSA with ADHD (n = 42), ADHD without OSA (n = 54), and controls without either condition (n = 51). Mean and minimum oxygen saturations during sleep were comparable among all groups, with no statistically significant differences versus controls. Children with both OSA and ADHD had a higher frequency of medication use (24%) compared to OSA without ADHD (13%), ADHD without OSA (6%), and controls (8%) (p 0.05). Medications included inhaled corticosteroids, antihistamines, and leukotriene inhibitors. REM sleep percentage was lower than normal in all study groups, in those with ADHD and OSA the median was 9.8 (6.4- 17.0) compared to controls 12.8 (7.8- 18.4). The median apnea-hypopnea index (AHI) was 3.6 (2.5-4.3) in OSA without ADHD and 2.7 (1.6-6.0) in OSA with ADHD. Those with ADHD and OSA had a higher mean frequency of micro-awakenings (6.9% ± 5.1) compared to those with OSA but without ADHD (5.4% ± 4.0). Conclusions ADHD is a frequent comorbidity among children with OSA living at high altitude. Children with OSA and ADHD exhibit distorted sleep architecture, predominantly a lower REM sleep percentage; the higher medication use in this group warrants further investigation. Larger multicenter studies are needed to better understand the interaction between OSA and ADHD in pediatric populations residing at high altitude. This abstract is funded by: Grant 874 Ministry of Science, Technology and Innovation, Colombia