Increased Platelet Aggregation in Children and Adolescents with Sleep-disordered Breathing

Area of Science:

• Pediatric cardiology
• Sleep medicine
• Hematology

Background:

• Sleep-disordered breathing (SDB) is linked to elevated vascular resistance and endothelial cell damage in adults.
• Platelet activation is a key marker of vascular endothelial damage.

Purpose of the Study:

• To compare whole-blood impedance platelet aggregation in children diagnosed with SDB requiring adenotonsillectomy versus healthy controls.
• To investigate the relationship between SDB severity and platelet aggregation markers.

Main Methods:

• Thirty children with SDB and 20 healthy children underwent polysomnography to assess SDB severity (obstructive apnea-hypopnea index).
• Whole-blood platelet aggregation was measured using aggregometers following stimulation with TRAP, COL antibody, ADP antibody, and aspirin dialuminate.
• Parental reports of snoring frequency were collected.

Main Results:

• Children with SDB demonstrated significantly higher platelet aggregation in response to TRAP and COL antibody compared to controls (P < 0.05).
• A trend towards increased aggregation was observed with ADP antibody (P < 0.07), but not with aspirin dialuminate.
• Snoring frequency, as reported by parents, was positively associated with TRAP-induced platelet aggregation (P < 0.05).

Conclusions:

• Increased platelet aggregation in children with SDB suggests endothelial damage, mirroring findings in adults.
• The cardiovascular changes associated with SDB in adults may also be present in pediatric populations.
• Platelet activation could be an early indicator of cardiovascular risk in children with SDB.