Pour informer les parents de certains de nos jeunes patients, et éventuellement le bien-être de ces derniers, il est intéressant de connaître les liens entre le syndrome d’apnées obstructives du sommeil (SAOS) et du trouble du déficit de l’attention / hyperactivité (TDAH). En effet, de nombreuses études ont démontré une association entre ces pathologies [1], avec une comorbidité qui peut dépasser 50% [2,3], alors que la prévalence du SAOS et du TDAH sont respectivement de 1.2-9.5% [4,5] et d’environ 5% [6] chez les enfants. Il a été proposé que la désaturation en oxygène causée par le SAOS nuit au développement et la fonction du cerveau, menant aux symptômes liés au TDAH [13]. Les facteurs de risques principaux du SAOS chez les enfants sont l’hypertrophie adéno-amygdalienne et l’obésité [1]. Par conséquent, l’ablation adéno-amygdalienne est le traitement le plus fréquent pour le SAOH chez les enfants [7]. Plusieurs études ont démontré que cette intervention chirurgicale mène à une amélioration significative des symptômes en lien avec le TDAH, supportant le lien entre ces deux pathologies [8-12]. À noter que l’impact des autres options thérapeutiques du SAOS sur les symptômes liés au TDAH chez les enfants n’a pas été adéquatement objectivé par des études.
Abstract
Abstract: Obstructive sleep apnea (OSA) is a form of sleep-disordered breathing that affects up to 9.5% of the pediatric population. Untreated OSA is associated with several complications, including neurobehavioral sequelae, growth and developmental delay, cardiovascular dysfunction, and insulin resistance. Attention-deficit/hyperactivity disorder (ADHD) is among the neurobehavioral sequelae associated with OSA. This review aims to summarize the research on the relationship between OSA and ADHD and investigate the impacts of OSA treatment on ADHD symptoms. A literature search was conducted on electronic databases with the key terms: “attention deficit hyperactivity disorder” or “ADHD”, “obstructive sleep apnea” or “OSA”, “sleep disordered breathing”, and “pediatric” or “children”. Review of relevant studies showed adenotonsillectomy to be effective in the short- term treatment of ADHD symptoms. The success of other treatment options, including continuous positive airway pressure (CPAP), in treating ADHD symptoms in pediatric OSA patients has not been adequately evaluated. Further studies are needed to evaluate the long-term benefits of surgical intervention, patient factors that may influence treatment success, and the potential benefits of other OSA treatment methods for pediatric ADHD patients.
Références
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