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Blood pressure associated with sleep-disordered breathing in a population sample of children

Edward O Bixler1, Alexandros N Vgontzas, Hung-Mo Lin

  • 1Department of Psychiatry, Penn State University College of Medicine, Sleep Research and Treatment Center, Hershey, PA 17033, USA. ebixler@hmc.psu.edu

Hypertension (Dallas, Tex. : 1979)
|October 8, 2008
PubMed

Insights

Sleep-disordered breathing (SDB) in children is linked to higher systolic blood pressure. This study suggests a threshold of apnea-hypopnea index (AHI) greater than or equal to 5 for initiating SDB treatment in children aged 5-12.

Area of Science:

  • Pediatric Sleep Medicine
  • Cardiovascular Health in Children
  • Respiratory Medicine

Background:

  • Current sleep-disordered breathing (SDB) diagnostic criteria in children lack clinically relevant outcome measures.
  • The association between SDB and cardiovascular parameters, specifically blood pressure, requires further investigation in pediatric populations.

Purpose of the Study:

  • To evaluate the relationship between SDB and blood pressure in a representative sample of elementary school children.
  • To determine if SDB is an independent risk factor for elevated blood pressure in children aged 5-12 years.

Main Methods:

  • A two-phased study involving 5740 elementary school children (grades K-5).
  • Phase 1: Questionnaire screening (78.5% response rate).
  • Phase 2: Polysomnography and clinical evaluations (ECG, ENT, pulmonary) in 700 randomly selected children (70.0% response rate).

Main Results:

  • A significant positive correlation was observed between the apnea-hypopnea index (AHI) and systolic blood pressure (e.g., AHI ≥5 associated with a 12.9 mm Hg increase).
  • This association remained significant after adjusting for confounding factors including age, sex, race, BMI, waist circumference, sleep efficiency, REM sleep, and snoring.
  • Independent predictors of elevated blood pressure included older age, higher BMI percentile, increased waist circumference, and snoring.

Conclusions:

  • Sleep-disordered breathing is significantly associated with elevated systolic blood pressure in children aged 5-12.
  • The findings support using an AHI threshold of ≥5 for initiating SDB treatment in children.
  • Further research is warranted to explore the impact of SDB treatment on blood pressure reduction.

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