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Sleep Med. 2013 Dec;14(12):1295-303. doi: 10.1016/j.sleep.2013.07.014. Epub 2013 Sep 29.

Improvement of sleep-disordered breathing in children is associated with a reduction in overnight blood pressure.

Author information

1
The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia.

Abstract

OBJECTIVE:

Childhood sleep-disordered breathing (SDB) is associated with elevated blood pressure (BP); however, little is known about the long-term outcomes in this population. We aimed to assess long-term changes in overnight BP in children with SDB.

METHODS:

Forty children with previously diagnosed SDB and 20 nonsnoring control participants underwent repeat overnight polysomnography (PSG) with continuous BP measurement 4years after the original diagnosis. At follow-up, children aged 11-16years were categorized into 2 groups of resolved (absence of snoring and obstructive apnea-hypopnea index [OAHI]⩽1) or unresolved (continued to snore or had an OAHI >1) SDB.

RESULTS:

There were no group differences in age, sex, or body mass index (BMI) z score. OAHI was lower at follow-up (P<.05) in both the resolved (n=18) and unresolved (n=22) groups. BP was elevated during wake and sleep in both SDB groups compared to the control group at baseline (P<.01 for all), but it decreased by 5-15mmHg at follow-up during sleep for both SDB groups (P<.05 for all). BP during wake was unchanged in the SDB groups at follow-up but increased in the control group (P<.05). At follow-up, BP did not differ between the control group and the SDB groups during wake or sleep. Improved oxygen saturation (SpO2) during sleep was a significant predictor of a reduction in BP.

CONCLUSIONS:

SDB improved over the 4-year follow-up and both resolved and unresolved groups exhibited a significant reduction in BP during sleep, with levels similar to the control group. Our study highlights the fact that even small improvements can improve the cardiovascular effects of SDB.

KEYWORDS:

Blood pressure; Follow-up; Heart rate; Obstructive sleep apnea; Pediatric sleep-disordered breathing; Treatment

PMID:
24157094
DOI:
10.1016/j.sleep.2013.07.014
[Indexed for MEDLINE]

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