Allergic Rhinitis and Hearing Loss Found Linked to ADHD in Children: What the New Research Reveals

A new population-based study from South Korea has uncovered a significant link between allergic rhinitis, hearing loss, and attention-deficit/hyperactivity disorder (ADHD) in children. The research, published in the International Journal of Environmental Research and Public Health in September 2025, suggests that children who experience both allergic rhinitis and hearing loss are more likely to have ADHD than those with either condition alone.

The study, led by Bo Ram Yang, Ph.D. from the Chungnam National University College of Pharmacy, and Bong Jik Kim from the Chungnam National University College of Medicine, analyzed medical records from nearly a decade of pediatric data to understand how these health issues overlap. Their findings point to a stronger-than-expected association that could influence how doctors screen and treat ADHD in the future.

The Data Behind the Findings

The researchers used data from the Korea Health Insurance Review and Assessment Service (HIRA-PPS) database, which collects detailed medical information from about 10 percent of the country’s population each year. They focused on children aged 6 to 19 years, using records spanning from 2009 to 2018—a large-scale dataset that included over 7.7 million non-ADHD participants and more than 66,000 children diagnosed with ADHD.

Children were identified as having ADHD if they had been prescribed methylphenidate or atomoxetine, two common ADHD medications. Hearing loss was confirmed when a child had been diagnosed under ICD-10 codes H90.x or H91.x and had undergone audiometric testing such as audiograms or auditory brainstem response tests. Allergic rhinitis, a chronic nasal allergy, was identified through diagnostic codes J30.x and confirmed through allergy testing like skin or immunoglobulin E (IgE) tests.

The study wasn’t limited to surface-level data. The researchers also ran sensitivity analyses using stricter definitions—such as counting only children diagnosed by specialists or those who underwent multiple hearing tests—to make sure their results were consistent.

What the Numbers Show

After adjusting for factors like age, sex, insurance type, and year, the analysis revealed that both allergic rhinitis and hearing loss were independently associated with a higher risk of ADHD.

Children with hearing loss had nearly 1.8 times higher odds of ADHD than those without hearing loss.
Those with allergic rhinitis had about 1.4 times higher odds of ADHD compared to children without allergies.
But children who had both conditions had the highest risk—around double the odds of having ADHD compared to those with neither condition.

These associations remained strong even after applying stricter statistical definitions and control measures. In simple terms, this wasn’t a fluke. The more health issues a child had (especially hearing loss combined with allergic rhinitis), the higher their likelihood of having ADHD.

Interestingly, the study found that girls with hearing loss had a stronger connection to ADHD than boys, despite ADHD being more commonly diagnosed in boys overall. This suggests that hearing issues might play a particularly important role in how ADHD symptoms develop—or are noticed—in girls.

Why This Connection Matters

At first glance, allergic rhinitis, hearing loss, and ADHD might seem unrelated. But when you think about how these conditions affect a child’s day-to-day life, the link starts to make sense.

Allergic rhinitis can cause chronic nasal inflammation, leading to poor sleep, fatigue, and cognitive sluggishness. Children who don’t sleep well or can’t breathe properly may show signs of inattention or hyperactivity.
Hearing loss, even mild, can interfere with communication, classroom performance, and social interaction. When children can’t hear instructions clearly, they may appear distracted, impulsive, or inattentive—symptoms that often overlap with ADHD.
The combination of chronic allergy-related inflammation and sensory impairment could stress the developing brain, possibly influencing attention and behavior pathways.

From a clinical standpoint, this research suggests that managing physical health issues could improve ADHD outcomes. Doctors and parents might need to look beyond behavior and pay attention to underlying health factors.

The Gender and Age Factors

While ADHD diagnoses are far more common in boys, this study found that girls with hearing loss had relatively higher odds of ADHD than boys with the same condition. This difference could be due to biological factors, diagnostic bias, or differences in how girls manifest attention problems.

The research also examined the association across age groups (6–9, 10–14, 15–19) and found that younger children with allergic rhinitis were slightly more affected, suggesting that early-life allergic inflammation might have a stronger influence on brain development.

What Makes This Study Stand Out

One strength of this study is its large-scale population-based design. With data from more than 7 million children over a ten-year period, the findings are statistically robust and not easily dismissed as coincidence. The inclusion of sensitivity analyses—testing different definitions and diagnostic conditions—added further reliability.

However, as the authors pointed out, this was a cross-sectional study, meaning it captured data at a single point in time rather than following children over years. Therefore, while it clearly shows an association, it cannot prove causation. In other words, we can’t yet say that allergic rhinitis or hearing loss causes ADHD—only that they tend to occur together more often than by chance.

Still, the evidence opens up important questions. Could chronic allergic inflammation impact neural development? Could communication difficulties from hearing loss lead to ADHD-like symptoms? Or do children with ADHD simply undergo more health checks, increasing the likelihood of discovering these other conditions? These are the kinds of questions future longitudinal studies could help answer.

What Parents and Clinicians Can Take Away

For parents, this research is a reminder that ADHD doesn’t exist in isolation. If a child has attention issues, it may be worth checking for other physical health problems—especially hearing difficulties or persistent allergies.

For clinicians, it highlights the importance of integrated care. Treating allergic rhinitis or addressing hearing loss could indirectly improve ADHD symptoms by removing underlying stressors on the brain and body. This approach emphasizes whole-child health, not just symptom management.

And for educators, the findings reinforce how crucial it is to ensure that every child can hear clearly and breathe comfortably in learning environments. Sometimes what looks like inattention might simply be a health issue that’s getting in the way of focus.

A Broader Look: Allergies, the Brain, and Behavior

Researchers have long been exploring the relationship between immune system activity and brain function. Inflammatory processes triggered by allergic diseases may influence neurotransmitters like dopamine and norepinephrine, which are crucial for attention and impulse control. Similarly, chronic inflammation can affect sleep quality and mood regulation, both key factors in ADHD.

While much of this field is still being studied, the idea that physical health and mental focus are deeply connected is gaining traction. The body and mind don’t operate separately—and this new study adds one more piece to that puzzle.