Background: Attention Deficit Hyperactivity Disorder (ADHD) and Sleep Disordered Breathing (SDB) are conditions that are commonly found and diagnosed in pediatric patients with potential interplay. Understanding their association is crucial for early intervention, and management. Objective: This study aims to determine the prevalence and association of ADHD among pediatric patients with Sleep Disordered Breathing (SDB) between the age 3-6 years old in the eastern province. Method: A cross-sectional study design was employed. An online survey including the ADHD rating scale IV – preschool version and the Pediatric Sleep Questionnaire (PSQ) was distributed to parents of children aged 3-6. The case group comprised SDB-positive patients awaiting adenotonsillectomy, while the control group consisted of age-matched children with negative PSQ screenings. Exclusion criteria included prior adenotonsillectomy, psychiatric follow-ups, and other mental disorders. Sampling involved contacting parents of children scheduled for adenotonsillectomy between March 2023 and January 2024. Data analysis was conducted by a biostatistician. Results: 3.3% was the overall prevalence of positive ADHD screenings in both groups (n = 2), with 5% in the case group (n = 1) and 2.5% in the controls (n = 1). 20% of the case group showed hyperactivity/impulsivity alone, 0% percent showed inattentiveness alone, and 5% showed both. Within the control group, 2.5 percent showed impulsivity or hyperactivity on its own, 2.5% showed inattention on its own, and 5% showed both. Even though the case group’s ADHD scores were higher, there was no statistically considerable difference that would prove the relationship between ADHD and SDB. However, a statistically significant positive correlation was found between PSQ scores and ADHD subscales. Conclusion: While a higher prevalence of ADHD symptoms was observed in pediatric SDB patients, the study did not find a statistically significant association, except in the relationship with raw scores of PSQ and ADHD symptoms. Further research with larger sample sizes is warranted to elucidate the relationship between ADHD and SDB in children.

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