A 4-year prospective follow-up study of childhood OSA and its association with BP

Area of Science:

• Pediatric Sleep Medicine
• Cardiovascular Health in Children
• Obesity and Sleep Disorders

Background:

• Childhood obstructive sleep apnea (OSA) is a common condition linked to elevated blood pressure (BP) in cross-sectional studies.
• Longitudinal data are needed to understand the relationship between OSA severity and BP over time.

Purpose of the Study:

• To investigate the association between baseline and changes in obstructive sleep apnea (OSA) severity and ambulatory blood pressure (BP) at a 4-year follow-up in children.
• To determine if this association differs between normal-weight and overweight children.

Main Methods:

• A 4-year follow-up study involving repeat overnight sleep studies and 24-h ambulatory BP monitoring.
• Comparison of BP parameters across different baseline obstructive apnea-hypopnea index (OAHI) severity groups (<1/h, 1-5/h, >5/h).
• Separate analysis for overweight and normal-weight children, adjusting for BMI z score.

Main Results:

• Linear increasing trends in wake systolic BP (SBP), wake diastolic BP (DBP), and sleep SBP z scores were observed with increasing baseline OSA severity in normal-weight children.
• Baseline obstructive apnea-hypopnea index (OAHI) was independently associated with all BP z scores at follow-up in normal-weight children, independent of BMI z score.
• Changes in OAHI were independently associated with follow-up sleep SBP and DBP z scores and their changes over 4 years.

Conclusions:

• Childhood OSA is associated with elevated BP, independent of obesity.
• Both baseline OSA severity and changes in severity over time are significant predictors of ambulatory BP in children.