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Impaired blood pressure control in children with obstructive sleep apnea

Lisa M Walter1, Stephanie R Yiallourou, Anna Vlahandonis

  • 1The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia. lisa.walter@monash.edu

Sleep Medicine
|June 18, 2013
PubMed

Insights

Children with obstructive sleep apnea (OSA) show impaired baroreflex sensitivity (BRS) and increased blood pressure variability (BPV). This suggests altered autonomic control in pediatric OSA, warranting further investigation into treatment effects.

Area of Science:

  • Pediatric cardiology
  • Sleep medicine
  • Autonomic nervous system function

Background:

  • Obstructive sleep apnea (OSA) in adults is linked to hypertension, reduced baroreflex sensitivity (BRS), delayed heart rate response (HPD), and increased blood pressure variability (BPV).
  • While children with OSA have higher blood pressure, data on their BRS, BPV, and HPD are limited.
  • Impaired BRS may contribute to hypertension by affecting blood pressure control, leading to increased BPV and HPD.

Purpose of the Study:

  • To investigate baroreflex sensitivity (BRS), heart period delay (HPD), and blood pressure variability (BPV) in children with obstructive sleep apnea (OSA).
  • To compare these cardiovascular autonomic parameters between children with OSA and non-snoring controls.

Main Methods:

  • 105 children (ages 7-12) referred for OSA assessment and 36 controls underwent overnight polysomnography (PSG) with continuous blood pressure monitoring.
  • Subjects were categorized into primary snoring (PS), mild OSA, and moderate/severe (MS) OSA based on their obstructive apnea-hypopnea index (OAHI).
  • BRS and HPD were calculated using cross-spectral analysis, and BPV using power spectral analysis.

Main Results:

  • Children with OSA exhibited significantly lower BRS and longer HPD compared to controls.
  • The moderate/severe (MS) OSA group showed higher BPV across all frequencies (low and high) than control and primary snoring groups.
  • These findings indicate reduced baroreflex function in children with OSA.

Conclusions:

  • Pediatric obstructive sleep apnea (OSA) is associated with reduced baroreflex sensitivity (BRS), prolonged heart period delay (HPD), and elevated blood pressure variability (BPV).
  • These results suggest altered baroreflex function in children with OSA.
  • Longitudinal studies are needed to determine if OSA treatment can reverse these changes in baroreflex response.
Abstract

Keywords:
Baroreflex sensitivityBlood pressure variabilityHeart period delayPediatricSleepSleep apneaSleep-disordered breathing

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