Analysis of 24-hour ambulatory blood pressure monitoring in children with obstructive sleep apnea: A hospital-based study
Journal
Medicine (United States)
Journal Volume
94
Journal Issue
40
Pages
e1568
Date Issued
2015
Author(s)
Abstract
In the present study, we aimed to verify associations between ambulatory blood pressure (ABP) and pediatric obstructive sleep apnea (OSA) in a hospital-based population. This was a cross-sectional observational study on children aged 4 to 16 years with OSA-related symptoms from a tertiary referral medical center. All children received overnight polysomnography and 24-hour recording of ABP. Severity of the disease was classified as primary snoring (apnea-hypopnea index, AHI <1), mild OSA (AHI 1-5), and moderate-to-severe OSA (AHI >5). For 195 children enrolled in this study (mean age, 7.8±3.4 years; 69% boy), ABP increased as severity of OSA increased. During daytime, children with moderate-to-severe OSA had significantly higher systolic blood pressure (BP) (117.0±12.7 vs 110.5±9.3 mmHg), mean arterial pressure (MAP) (85.6±8.1 vs 81.6±6.8 mmHg), and diastolic BP load (12.0±9.6 vs 8.4±10.9mmHg) compared with children with primary snoring. During nighttime, children with moderate-to-severe OSA had significantly higher systolic BP (108.6±15.0 vs 100.0±9.4 mmHg), MAP (75.9±9.6 vs 71.1±7.0 mmHg), systolic BP load (44.0±32.6 vs 26.8±24.5mmHg), systolic BP index (0.5±13.1 vs 6.8±8.5 mmHg), and higher prevalence of systolic hypertension (47.6% vs 14.7 %) compared with children with primary snoring. Multiple linear regression analyses revealed an independent association between AHI and nighttime systolic BP and MAP after adjusting for adiposity variables. This large hospital-based study showed that children with moderateto-severe OSA had a higher ABP compared with children who were primary snorers. As elevated BP in childhood predicts future cardiovascular risks, children with severe OSA should be treated properly to prevent further adverse cardiovascular outcomes. ? 2015 Wolters Kluwer Health, Inc. All rights reserved.
SDGs
Other Subjects
adolescent; apnea hypopnea index; Article; blood pressure monitoring; cardiovascular risk; child; childhood disease; childhood obesity; cross-sectional study; daytime somnolence; diastolic blood pressure; disease severity; female; human; major clinical study; male; mean arterial pressure; observational study; oxygen desaturation; polysomnography; prevalence; priority journal; REM sleep; sleep disordered breathing; sleep quality; sleep time; snoring; systolic blood pressure; tertiary care center; complication; hypertension; pathophysiology; preschool child; regression analysis; sleep disordered breathing; Adolescent; Blood Pressure Monitoring, Ambulatory; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Hypertension; Male; Polysomnography; Regression Analysis; Sleep Apnea, Obstructive
Publisher
Lippincott Williams and Wilkins
Type
journal article