Objective To explore synergistic effect of asthma and sleep disorders on attention-deficit/hyperactivity disorder (ADHD) in preschool children.
Methods We conducted a survey among 16 439 children aged 3 – 6 years and their primary caregivers recruited in 91 of 93 kindergartens registered in Ma'anshan city of Anhui province between April and June 2016. Information on sleep disorders and medically diagnosed asthma in the children were collected with a self-designed questionnaire; the Conners′ 10-Item Abbreviated Symptom Questionnaire – Chinese version (ASQ-C) was administered to assess ADHD symptoms. Unconditional logistic regression was adopted to analyze the synergistic effect.
Results After adjusting for interactive effect of asthma and sleep disorders and potential confounders such as maternal education, being a only child, registered permanent residence, gender, age, daily time of watching television, and passive smoking, asthma and sleep disorders were positively associated with ADHD symptoms (adjusted odd ratio aOR for asthma: 1.45, 95% confidence interval 95% CI: 1.11 – 1.89; aOR for sleep disorders: 2.88, 95% CI: 2.56 – 3.25) in the children. The children with both asthma and sleep disorder had a higher risk of ADHD symptoms (OR = 4.3, 95% CI: 3.06 – 6.04) compared to those only with asthma (OR = 1.35, 95% CI: 0.88 – 2.07) and those only with sleep disorder (OR = 2.86, 95% CI: 2.53 – 3.24). The synergy index of asthma and sleep disorders on ADHD was 1.49 in the children.
Conclusion Asthma and sleep disorder has a synergistic effect on the occurrence of ADHD symptoms in preschool children.
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