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Baroreflex gain in children with obstructive sleep apnea
Keith McConnell1, Virend K Somers, Thomas Kimball
1Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
American Journal of Respiratory and Critical Care Medicine
|March 17, 2009
Summary
Children with obstructive sleep apnea (OSA) have reduced nighttime baroreflex gain, leading to increased blood pressure variability. This variability is linked to changes in left ventricular mass index, indicating potential end-organ damage.
Area of Science:
- Cardiology
- Pediatrics
- Sleep Medicine
Background:
- Obstructive sleep apnea (OSA) in children is linked to elevated blood pressure and altered left ventricular mass index.
- Blood pressure variability (BPV) is a known predictor of cardiac changes in adults.
- The baroreflex system regulates blood pressure by adjusting heart rate.
Purpose of the Study:
- To compare left ventricular mass index (LVMI) and nighttime baroreflex gain between healthy children and those with OSA.
- To investigate the relationship between OSA, baroreflex function, and cardiac parameters.
Main Methods:
- 169 children (50 controls, 63 mild OSA, 56 severe OSA) underwent echocardiography and polysomnography with continuous blood pressure monitoring.
- Baroreflex gain was assessed using time and frequency domain analyses during sleep.
- Left ventricular mass index was measured via echocardiography.
Main Results:
- Healthy children exhibited increased baroreflex gain during sleep.
- Children with OSA demonstrated significantly lower nighttime baroreflex gain compared to controls.
- Nighttime blood pressure and BPV were significantly correlated with LVMI.
Conclusions:
- Obstructive sleep apnea in children is associated with diminished nighttime baroreflex gain.
- Reduced baroreflex gain contributes to increased blood pressure variability in children with OSA.
- Elevated blood pressure variability in OSA is correlated with cardiac structural changes (LVMI).
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