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Blood pressure in sleep disordered breathing
J Kohyama1, J S Ohinata, T Hasegawa
1Division of Human Ontogeny and Childhood Development, Graduate School, Tokyo Medical & Dental University, 1-5-45 Yushima, Tokyo 113-8519, Japan. jkohyama.ped@tmd.ac.jp
Insights
Children with sleep disordered breathing (SDB) show elevated blood pressure (BP) that correlates with SDB severity. Higher apnea-hypopnea index (AHI) indicates worse SDB and higher BP indices in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Sleep Medicine
- Cardiovascular Physiology
Background:
- Sleep disordered breathing (SDB) is increasingly recognized in children.
- The relationship between SDB and cardiovascular parameters like blood pressure (BP) requires further investigation in pediatric populations.
- Adenotonsillar hypertrophy is a common cause of SDB in children.
Purpose of the Study:
- To investigate the association between blood pressure (BP) and sleep disordered breathing (SDB) in children.
- To determine if SDB severity, measured by polysomnography indices, correlates with BP in pediatric patients.
Main Methods:
- Blood pressure (BP) was measured during polysomnography in 23 children with suspected SDB and adenotonsillar hypertrophy.
- BP indices were normalized to age-related changes and analyzed against SDB measures including desaturation time, SaO2 nadir, apnea-hypopnea index (AHI), and arousal index.
- Multiple regression analysis was used to identify predictors of BP indices.
Main Results:
- The diastolic BP index during REM sleep significantly correlated with the apnea-hypopnea index (AHI).
- Children with an AHI of 10 or more exhibited significantly higher systolic and diastolic BP indices during wakefulness and REM sleep compared to those with lower AHI.
- Age, BMI, and AHI were significant predictors of the systolic BP index during REM sleep.
Conclusions:
- Blood pressure in pediatric SDB patients is positively correlated with the degree of SDB severity.
- SDB severity, particularly the AHI, is a significant factor influencing BP in children.
- These findings highlight the cardiovascular implications of SDB in pediatric populations.
Aims:
To investigate blood pressure (BP) in children with sleep disordered breathing (SDB).
Methods:
BP was measured during single night polysomnography in 23 suspected SDB child patients with adenotonsillar hypertrophy, but without respiratory or heart failure, or coma. The age related changes of the observed BP were normalised to the BP index. The BP indices were examined in relation to SDB measures, such as the desaturation time (percentage of time with oxygen saturation (SaO2) <90% against the total sleep time), SaO2 nadir, apnoea-hypopnoea index (AHI), and arousal index, in addition to age and body mass index (BMI).
Results:
The systolic BP index during rapid eye movement sleep (REMS) tended to correlate with AHI, while the diastolic index during REM sleep showed a significant correlation with AHI. The BP indices during non-REMS and wakefulness showed no correlation with the parameters obtained. Patients with an AHI of 10 or more (n = 7, AHIhigh) had significantly higher systolic and diastolic BP indices during both wakefulness and REMS, compared with those with an AHI of less than 10 (n = 16, AHIlow). Two patients in AHIhigh showed no sleep related dip of diastolic BP, and three patients in AHIlow lacked the sleep related dip in systolic BP. By means of multiple regression analysis, age, BMI, and AHI were found to be significant predictor variables of the systolic BP index during REMS.
Conclusions:
BP in paediatric SDB patients is positively correlated with the degree of SDB.