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Ambulatory blood pressure monitoring in children undergoing polysomnography
Lourdes M DelRosso1,2, Jeremy Chan1,2, Chris Ruth1
1Seattle Children's Hospital, Seattle, WA, USA.
Insights
Ambulatory blood pressure monitoring (ABPM) during polysomnography (PSG) is feasible in children. This combined approach helps detect nocturnal hypertension, a risk factor for cardiovascular issues, in high-risk youth.
Area of Science:
- Pediatric Cardiology
- Sleep Medicine
- Hypertension Research
Background:
- Ambulatory blood pressure monitoring (ABPM) is crucial for diagnosing hypertension in high-risk children, including those with obesity or obstructive sleep apnea (OSA).
- Nocturnal hypertension significantly predicts cardiovascular outcomes, necessitating early detection in pediatric populations.
- While OSA is common, other sleep disorders also increase cardiovascular risk, highlighting the need for early diagnosis in at-risk children.
Purpose of the Study:
- To assess the feasibility of simultaneously performing ABPM during polysomnography (PSG) in children referred for sleep disordered breathing.
- To determine if combining ABPM with PSG affects sleep parameters in pediatric patients.
Main Methods:
- The study included 41 children aged 7-18 years undergoing PSG for sleep disordered breathing.
- ABPM was concurrently applied during PSG, with the monitor worn for an average of 10.2 hours.
- Sleep parameters, including sleep efficiency and arousals, were analyzed to assess the impact of co-performed ABPM.
Main Results:
- Co-performing ABPM during PSG did not significantly alter key sleep parameters like sleep efficiency or arousals.
- Out of 41 participants, 12 children (29%) were identified with nocturnal hypertension.
- The study demonstrated the successful integration of ABPM into PSG protocols for children.
Conclusions:
- Simultaneous ABPM and PSG is a feasible and safe method for evaluating children with sleep disordered breathing.
- This combined approach facilitates the early identification of nocturnal hypertension in pediatric patients at high cardiovascular risk.
- Early detection of nocturnal hypertension through combined ABPM and PSG can inform timely interventions to mitigate cardiovascular risks.
Abstract:
Ambulatory blood pressure monitoring (ABPM) is recommended for the diagnosis of hypertension in children at high risk, such as children with obesity or obstructive sleep apnea (OSA). Nocturnal hypertension is highly predictive of cardiovascular outcomes. ABPM allows for early detection of nocturnal hypertension in children. Although OSA is the most common sleep disorder associated with hypertension, studies have also shown an increase in cardiovascular risk in adult patients with other sleep disorders; therefore, there is an imperative need to provide early diagnosis in children at high risk. In the present study, we evaluated the feasibility of using ABPM during polysomnography (PSG) in children referred for sleep disordered breathing to the Seattle Children's Hospital Sleep Disorders Center. A total of 41 children aged 7-18 years were included in this study. The ABPM monitor was worn for a mean (SD) of 10.2 (1.5) hr. No significant changes were seen in PSG parameters when ABPM was co-performed with PSG, including sleep efficiency and arousals. In total, 12 of the 41 patients were identified as having nocturnal hypertension. Our study is important in that it shows that concomitant use of ABPM during PSG can aid in the early identification of nocturnal hypertension in this population.
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