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Prevalence of pulmonary hypertension on echocardiogram in children with severe obstructive sleep apnea

Melissa A Maloney1, Sally L Davidson Ward1,2, Jennifer A Su2,3

  • 1Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|February 25, 2022
PubMed

Insights

Pulmonary hypertension (PH) is common in children with severe obstructive sleep apnea (OSA). Screening may be more effective for children with sleep-related hypoventilation or Down syndrome.

Area of Science:

  • Pediatric Cardiology
  • Sleep Medicine
  • Pulmonology

Background:

  • Pulmonary hypertension (PH) is a serious complication of obstructive sleep apnea (OSA).
  • Echocardiographic screening for PH is recommended in children with severe OSA.
  • Universal screening poses a significant healthcare burden.

Purpose of the Study:

  • To determine the prevalence of PH in children with severe OSA using echocardiography.
  • To identify variables associated with a positive PH screen in this population.

Main Methods:

  • Retrospective study of 318 children with severe OSA (apnea-hypopnea index ≥ 10).
  • Echocardiograms were performed within 1 year of polysomnography.
  • PH was defined by specific echocardiographic criteria indicating elevated pulmonary artery pressure.

Main Results:

  • 8.2% of children with severe OSA had echocardiographic evidence of PH.
  • Sleep-related hypoventilation (adjusted prevalence ratio = 2.73) and Down syndrome (adjusted prevalence ratio = 3.11) were associated with increased PH prevalence.
  • No significant differences in age, sex, BMI, or oxygenation indices were found between PH-positive and PH-negative groups.

Conclusions:

  • A notable prevalence of PH exists in children with severe OSA.
  • Targeted screening for PH may be beneficial for pediatric OSA patients with sleep-related hypoventilation or Down syndrome.
Abstract

Keywords:
echocardiogramobstructive sleep apneapediatricspulmonary hypertension

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