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Twenty-four-hour ambulatory BP in snoring children with obstructive sleep apnea syndrome

Lettie C K Leung1, Daniel K Ng, Michael W Lau

  • 1Department of Pediatrics, Kwong Wah Hospital, Waterloo Rd, Hong Kong SAR, China.

Chest
|October 13, 2006
PubMed

Insights

Children with obstructive sleep apnea syndrome (OSAS) have higher blood pressure, especially when asleep. Obesity and increased desaturation index are key factors linked to hypertension in these children.

Area of Science:

  • Pediatrics
  • Sleep Medicine
  • Cardiology

Background:

  • Obstructive sleep apnea syndrome (OSAS) is a recognized hypertension risk factor in adults, but its role in childhood hypertension is less understood.
  • Childhood OSAS may contribute to elevated blood pressure, necessitating further investigation beyond casual BP measurements.

Purpose of the Study:

  • To investigate the association between OSAS and 24-hour ambulatory blood pressure (ABP) in children presenting with snoring.
  • To determine if OSAS severity correlates with blood pressure variations during sleep and wakefulness in pediatric subjects.

Main Methods:

  • Recruited 96 children (aged 6-15 years) with snoring for polysomnography and 24-hour ABP monitoring.
  • Classified children into high apnea-hypopnea index (AHI > 5/h) and low-AHI (≤ 5/h) groups.
  • Analyzed systolic BP (SBP) and diastolic BP (DBP) during sleep, wake, and 24-hour periods, identifying "nondipper" BP patterns.

Main Results:

  • The high-AHI group exhibited significantly higher SBP when awake and higher SBP and DBP during sleep compared to the low-AHI group.
  • Body Mass Index (BMI) z-score was a significant predictor for both wake and sleep SBP, and sleep DBP.
  • Hypertension (17% of children) was exclusively observed in "nondipper" children, with obese children in the high-AHI group showing a higher prevalence.

Conclusions:

  • Increased desaturation index (DI) is a significant contributor to elevated sleep diastolic blood pressure (DBP) in children with snoring.
  • Obesity exacerbates the relationship between OSAS severity and hypertension prevalence in children.
  • Findings highlight the importance of assessing nocturnal BP patterns and OSAS in pediatric hypertension management.
Abstract

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