Obstructive sleep apnea in children is associated with severity-dependent deterioration in overnight endothelial
Leila Kheirandish-Gozal1, Tamar Etzioni, Rakesh Bhattacharjee
1Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL 60637-1470, USA. lgozal@peds.bsd.uchicago.edu
Sleep Medicine
|May 7, 2013
Summary
Pediatric obstructive sleep apnea (OSA) worsens endothelial function (EF) overnight, with severity correlating to the decline. The reactive hyperemia test reliably assesses EF changes in children with OSA.
Area of Science:
- Pediatric Sleep Medicine
- Cardiovascular Physiology
- Endothelial Function Research
Background:
- Restorative sleep typically improves endothelial function (EF) by morning.
- Obstructive sleep apnea (OSA) adversely affects EF, causing nocturnal worsening.
- Limited data exists on pediatric OSA and its impact on overnight EF changes.
Purpose of the Study:
- To investigate the association between pediatric obstructive sleep apnea (OSA) and overnight changes in endothelial function (EF).
- To explore overnight EF alterations in children with varying degrees of sleep-disordered breathing.
Main Methods:
- Assessed EF using reactive hyperemia test (EndoPAT) in 59 children (4-16 years) before and after overnight polysomnography (PSG).
- Evaluated EF changes in relation to OSA severity and polysomnographic parameters.
- Tested brachial occlusion periods of 1 and 5 minutes for EF assessment.
Main Results:
- Endothelial function (EF) deteriorated overnight in children with OSA, with changes dependent on OSA severity.
- Both 1-minute and 5-minute brachial occlusion periods yielded similar EF assessment findings.
- A significant correlation was observed between nocturnal EF deterioration and OSA severity in children.
Conclusions:
- Nocturnal endothelial dysfunction (ED) in children significantly correlates with obstructive sleep apnea (OSA) severity.
- The reactive hyperemia test is reliable for assessing pediatric EF with a 60-second occlusion period.
- Pediatric OSA leads to endothelial dysfunction, similar to adults, potentially explaining fewer cardiovascular complications due to shorter disease duration.
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