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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Pressure / physiology*
  • Child
  • Female
  • Follow-Up Studies
  • Heart Rate / physiology
  • Humans
  • Male
  • Photoplethysmography
  • Polysomnography
  • Sleep / physiology
  • Sleep Apnea Syndromes / physiopathology*
  • Sleep Apnea Syndromes / therapy*
  • Sleep, REM / physiology
  • Snoring / physiopathology
  • Snoring / therapy