Twenty-four-hour ambulatory blood pressure in children with sleep-disordered breathing

Area of Science:

• Pediatric Sleep Medicine
• Cardiovascular Physiology
• Respiratory Medicine

Background:

• Obstructive sleep apnea (OSA) is known to cause intermittent high blood pressure (BP) during sleep.
• The tonic effect of pediatric OSA on diurnal BP remains less understood.

Purpose of the Study:

• To investigate the impact of obstructive sleep apnea on 24-hour ambulatory blood pressure patterns in children.
• To determine if OSA contributes to tonic BP dysregulation throughout the day and night.

Main Methods:

• 24-hour ambulatory BP monitoring was performed on 60 children (mean age 10.8 years).
• Participants were divided into two groups: 39 with OSA and 21 with primary snoring.
• Analysis included BP variability, night-to-day BP ratios, nocturnal dipping, and correlations with OSA severity indices.

Main Results:

• Children with OSA exhibited greater BP variability during wakefulness and sleep compared to primary snorers.
• OSA patients showed a higher night-to-day systolic BP ratio and reduced nocturnal BP dipping.
• While no significant differences in sleep BP existed, wakefulness diastolic BP was lower in OSA and correlated with the apnea-hypopnea index.

Conclusions:

• Pediatric obstructive sleep apnea is associated with significant 24-hour BP dysregulation.
• Factors like apnea frequency, oxygen desaturation, and arousal contribute to abnormal BP control in children with OSA, irrespective of body mass index.
• OSA negatively affects BP variability and nocturnal dipping patterns, indicating a sustained impact on cardiovascular regulation.